Bronchial arterial aneurysm refers to any form of aneurysmal dilatation involving any segment of the bronchial artery. The term is sometimes used synonymously with a bronchial arterial pseudoaneurysm 2.
They are a rare entity and are reported in <1% of those who undergo selective bronchial arterial angiograms 8.
Their exact pathogenesis is not well known. Most cases have been reported in patients with the following background conditions:
- lung cancer
- recurrent infection
- thoracic trauma
- Rendu-Osler-Weber syndrome 2
Bronchial artery aneurysms have also been found in individuals with predisposing congenital conditions and systemic vascular diseases such as cystic fibrosis 3 and atherosclerosis. In patients without predisposing pulmonary or systemic disease, bronchial artery aneurysms are extremely rare.
They can be mediastinal (juxta-aortic) or intrapulmonary.
Treatment and prognosis
The treatment options for bronchial artery aneurysm include transcatheter embolisation, placement of a covered stent, and surgery.
Catastrophic haemorrhage is is one of the most feared complications.
- 1. Lü PH, Wang LF, Su YS et-al. Endovascular therapy of bronchial artery aneurysm: five cases with six aneurysms. Cardiovasc Intervent Radiol. 2011;34 (3): 508-12. doi:10.1007/s00270-010-9895-x - Pubmed citation
- 2. Yoon W, Kim JK, Kim YH et-al. Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review. Radiographics. 22 (6): 1395-409. Radiographics (citation) - Pubmed citation
- 3. Kalva SP, Wicky S. Mediastinal bronchial artery aneurysms: endovascular therapy in two patients. Catheter Cardiovasc Interv. 2006;68 (6): 858-61. doi:10.1002/ccd.20902 - Pubmed citation
- 4. Yanagihara K, Ueno Y, Kobayashi T et-al. Bronchial artery aneurysm. Ann. Thorac. Surg. 1999;67 (3): 854-5. Ann. Thorac. Surg. (link) - Pubmed citation
- 5. Wilson SR, Winger DI, Katz DS. CT visualization of mediastinal bronchial artery aneurysm. AJR Am J Roentgenol. 2006;187 (5): W544-5. doi:10.2214/AJR.06.0291 - Pubmed citation
- 6. Remy-jardin M, Remy J, Ramon P et-al. Mediastinal bronchial artery aneurysm: dynamic computed tomography appearance. Cardiovasc Intervent Radiol. 14 (2): 118-20. - Pubmed citation
- 7. Shaer AH, Bashist B. Computed tomography of bronchial artery aneurysm with erosion into the esophagus. J Comput Assist Tomogr. 13 (6): 1069-71. - Pubmed citation
- 8. Zhang LJ, Yang GF, Lu GM. Noninvasive diagnosis of bronchial artery aneurysm using dual-source computed tomography angiography. Acta Radiol. 2008;49 (3): 291-4. doi:10.1080/02841850701753714 - Pubmed citation
- 9. Vernhet H, Bousquet C, Jean B et-al. Bronchial aneurysms mimicking aortic aneurysms: endovascular treatment in two patients. Cardiovasc Intervent Radiol. 22 (3): 254-7. Cardiovasc Intervent Radiol (link) - Pubmed citation