Massive hemoptysis due to multiple bronchial artery aneurysms and multiple aneurysmal dilations: A case report

Use of a triple-coaxial system in coil embolization of a large bronchial artery aneurysm

An 84-year-old man presented with a large bronchial artery aneurysm with a tortuous afferent artery. A triple-coaxial system was used to perform super-selective catheterization, consisting of a small microcatheter, a large microcatheter, and a 4-Fr catheter. The large microcatheter was successfully placed inside the aneurysm, and coil embolization was performed using large detachable coils to reduce the procedure cost.

Endovascular Treatment of Incidentally Found Multiple Aneurysms Originating from a Bronchial Artery: A Case Report

Bronchial artery aneurysm (BAA) is a rare disease, and multiple aneurysms of a single bronchial artery are rarer. Regardless of the size of the lesion, it is at risk of rupture and can cause massive hemoptysis or severe pain. We report a rare case of bronchial artery embolization (BAE) of multiple aneurysms of a single bronchial artery. During medical examination, a 64-year-old female was diagnosed with multiple BAAs and endobronchial lesions in the right lower lung on CT 10 years prior to presentation to our hospital. Further evaluation of the lesions was recommended; however, the patient was lost to follow-up. The patient complained of dyspnea and visited our hospital, and the size of the BAA had increased on CT. BAE was done successfully using N-butyl-2-cyanoacrylate and detachable coils. Follow up CT after BAE showed significant decrease in extent of inflammatory lesion in the right lung.

Interlocking detachable coil embolization for giant tandem bronchial aneurysms: A case report

RATIONALE

Bronchial artery aneurysm (BAA) is a rare disease that can be life-threatening if it ruptures. Tandem connections of multiple aneurysms are even rarer and more challenging to manage.

PATIENT CONCERNS

A 46-year-old woman presented to the hospital with intermittent hemoptysis for a week. A bronchial artery computed tomographic angiography scan revealed 2 BAAs associated with bronchial artery-to-pulmonary artery fistulas in the left lung. Three-dimensional CT reconstruction showed 2 bronchial aneurysms in tandem and 1 aneurysm adjacent to the descending aorta.

DIAGNOSES

Giant tandem bronchial aneurysms were confirmed using computerized tomographic angiography.

INTERVENTIONS

Nine interlocking detachable coils and 11 standard pushable coils were introduced into aneurysms for embolization.

OUTCOMES

There was no episodes of hemoptysis. CT angiography indicated that the coils were closely knit and in their proper position 1 month later; at follow-up, the patient had no adverse effects and no recurrence of hemoptysis.

LESSONS

BAA is a rare disease that can be life-threatening if it ruptures. It should be treated aggressively to determine the presence of symptoms.