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

      case-report

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          Abstract

          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.

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          Most cited references16

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          Giant mediastinal bronchial artery aneurysm mimicking benign esophageal tumor: a case report and review of 26 cases from literature

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            Endovascular therapy of bronchial artery aneurysm: five cases with six aneurysms.

            The objective of this study was to investigate the effect of transcatheter arterial embolization (TAE) with N-butyl-2-cyanoacrylate (NBCA)-Lipiodol mixture in patients with bronchial artery aneurysm (BAA). From January 2005 to January 2010, five patients presenting hemoptysis with six BAAs were treated with NBCA-Lipiodol mixture, including intra-aneurysm embolization (IAE) in one patient. Adjuvant embolization with spherical polyvinyl alcohol (PVA) embolic microparticles or NBCA was first performed to embolize the distal engorged bronchiectatic arteries. Bronchial arterial angiography showed six BAAs (four in the right lobe and two in the left lobe) and some engorged, tortuous bronchial arteries. TAE through microcatheter was successful in all cases. Postembolization angiogram demonstrated the NBCA cast and total occlusion of BAAs and bronchiectatic engorged vessels. After these procedures, hemoptysis completely disappeared in all patients. Follow-up computed tomography (CT) scan was performed at an average of 3 months (range 2 to 6), which showed no enhancement of BAAs and accumulation of NBCA. TAE is a minimally invasive, effective, and reliable approach for treatment for patients with BAA. NBCA-Lipiodol mixture provides a good choice for treatment of BAA, especially when catheterization of the efferent branches is impossible.
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              • Record: found
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              • Article: not found

              Multiple bronchial artery aneurysms: Successful treatment with ethylene-vinyl alcohol copolymer (Onyx®)

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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0025-7974
                1536-5964
                23 December 2021
                23 December 2021
                : 100
                : 51
                : e28416
                Affiliations
                [a ]School of Medicine, Jianghan University
                [b ]Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
                [c ]Institution of Pulmonary Vascular Disease, Jianghan University, China.
                Author notes
                []Correspondence: Chenghong Li, Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University, Wuhan, China, and Institution of Pulmonary Vascular Disease, Jianghan University, No.168 Hongkong Road, Jiang’an District, Wuhan City 430000, Hubei Province, China (e-mail: 15827636399@ 123456163.com ).
                Author information
                http://orcid.org/0000-0002-1696-7297
                Article
                MD-D-21-07843 28416
                10.1097/MD.0000000000028416
                8702262
                34941187
                a25f86ab-5fe0-4d3e-81fb-075521143d71
                Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 19 November 2021
                : 6 December 2021
                Funding
                Funded by: Hubei Provincial Health Commission Fund Project
                Award ID: WJ2019F003
                Award Recipient : Not Applicable
                Categories
                6700
                Research Article
                Clinical Case Report
                Custom metadata
                TRUE

                bronchial artery aneurysm,bronchial artery embolization,interlocking detachable coils

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