Bronchial artery aneurysm

Case contributed by Oliver Hennessy

Presentation

Repeated hemoptysis. Congenital heart disease with multiple surgical procedures, valve replacements and pacemaker.

Patient Data

Age: 45 years old
Gender: Female
dsa

 

A right lower lobe bronchial artery was identified. A small false aneurysm arises from the distal aspect of this bronchial artery, with evidence of shunting into an adjacent pulmonary artery.

Using a SL10 microcatheter and Synchro Soft Neuroguidewire the distal bronchial artery was embolized using detachable GDC microcoils (X 2 Ultrasoft Target 360) occluding the vessel proximal to the false aneurysm.

It was impossible to pass the microwire or microcatheter beyond the false aneurysm, hence the proximal embolization.

The groin was closed using a 6-French Angioseal device.

Case Discussion

Bronchial artery aneurysms are rare, but may be associated with

  • prior instrumentation or prior cardiothoracic surgery
  • previous infection , particularly TB
  • Bronchiectasis and other suppuratives lung conditions
  • lung biopsy
  • thoracic trauma

Pulmonary artery aneurysms are more frequently encountered, often associated with vasculitides such as Behcet's syndrome, polyarteritis nodosa and Takayasu's disorder.

Embolization of bronchial artery aneurysms is the optimal treatment as they may rupture resulting in massive and life threatening hemoptysis

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