Bronchial artery pseudoaneurysm with symptomatic mediastinal hematoma

Kaufman, Claire; Kabutey, Nii-Kabu; Sgroi, Michael D.; Kim, Ducksoo

doi:10.1016/j.clinimag.2014.01.010

Cited by 18 publications

(18 citation statements)

References 12 publications

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“…A pseudoaneurysm is an organized collection of thrombus contained by subsequent fibrosis of the thrombus or by surrounding structures. The causes of a pseudoaneurysm can be trauma, infections, rupture of an aneurysm, iatrogenic causes, vasculitis, connective tissue disorder, malignancies, or even coagulopathies [3]. This patient probably had a spontaneous rupture of a contained aneurysm.…”

Section: Discussionmentioning

confidence: 90%

“…Bronchial artery aneurysms and pseudoaneurysms present with a wide range of symptoms that can mimic other medical conditions, the likely suspect in our case was a malignancy. Patients are usually asymptomatic, and lesions are found incidentally on CT chest [3]. Patients can present with hemoptysis [7,8] or hematemesis [9] when there is a rupture into the bronchus or esophagus, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…A false or a pseudoaneurysm is not bound by all the three layers of a vessel but contained by the adventitia or media or the soft tissue [2]. Bronchial artery aneurysm is a rare finding with less than one percent diagnosed by a bronchial angiogram [3,4]. Bronchial artery pseudoaneurysm is even rare with a limited number of published cases to date.…”

Section: Introductionmentioning

confidence: 99%

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A Rare Case of Ruptured Bronchial Artery Pseudoaneurysm and Its Nonsurgical Management With Interventional Techniques

Koirala¹,

Thapa²,

Mahat³

et al. 2020

Cureus

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Ruptured bronchial artery pseudoaneurysms with mediastinal hematoma are rare entities with a very limited number of published cases to date. The diagnosis of such cases can be difficult as the patient may present with symptoms mimicking other diseases, mainly mediastinal malignancy. A high degree of clinical suspicion and imaging techniques like contrast-enhanced computed tomography (CECT) chest and computed tomography angiography (CTA) aids in the diagnosis. Under the lights of an interventional radiologist, an urgent endovascular approach is most commonly preferred for its nonsurgical management. We present a rare case of a 47-yearold male with no previous lung disease or trauma with dyspnea and sudden onset chest pain. A massive effusion was suspected on the right side. CECT chest and digital subtraction angiography (DSA) revealed a pseudoaneurysm of a bronchial vessel with associated mediastinal hematoma, collapse of basal right lower lobe, and collection in right pleural space. This patient was later successfully treated by endovascular embolization techniques. Bronchial artery pseudoaneurysm may be considered a remote possibility in the absence of trauma or other lung diseases that may present with a massive hemothorax or mediastinal hematoma. Although CECT can be useful, digital angiography is considered the gold standard. Early intervention with the endovascular approach is a commonly recommended technique.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Rare Case of Ruptured Bronchial Artery Pseudoaneurysm and Its Nonsurgical Management With Interventional Techniques

Koirala¹,

Thapa²,

Mahat³

et al. 2020

Cureus

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“…5 Only four cases of bronchial artery pseudoaneurysm have been reported. [6][7][8][9] Pseudoaneurysms tend to occur as a result of inflammation or trauma. Thermal injury has been hypothesized as a mechanism for development of pseudoaneurysms in other locations after various types of procedures.…”

Section: Discussionmentioning

confidence: 99%

Bronchial Artery Pseudoaneurysm With Major Hemorrhage After Bronchial Thermoplasty

Nguyen

Murin

2016

Chest

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Bronchial thermoplasty has been found to be a safe and effective therapy for severe asthma. We report the case of a mediastinal hematoma and hemothorax developing in a 66-year-old woman several days after an uneventful bronchial thermoplasty of the right lower lobe. Evaluation revealed a bleeding right bronchial artery pseudoaneurysm. Pseudoaneuryms have been reported in association with other procedures involving the therapeutic application of thermal energy, and a single case of hemoptysis requiring bronchial artery embolization occurred in a clinical trial of bronchial thermoplasty. However, bronchial artery pseudoaneurysm with hemomediastinum and hemothorax has not previously been reported after bronchial thermoplasty.

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“…Bronchial artery aneurysm (BAA) is a rare but potentially lethal condition, and is reported less than 1% of all patients underwent selective bronchial arteriography (BAG). 1 – 3 The clinical presentation of a BAA, which depends on its size, location, and the presence of concomitant disease, can range from an incidental imaging finding to hemoptysis and shock caused by aneurysm rupture. 1 , 4 , 5 Correct diagnosis of this condition may be delayed because of its rarity and nonspecific presentation.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Embolization for Ruptured Ectopic Bronchial Artery Aneurysm

Shi¹,

Zhang³

et al. 2015

Medicine

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Bronchial artery aneurysm (BAA) is an uncommon disease, and spontaneous rupture of an ectopic BAA can be difficult for diagnosis and life-threatening. This case study describes a 52-year-old man who presented with acute onset of right chest pain, mild tachycardia, and hypertension. The initial diagnosis of acute myocardial infarction was made, and the patient was given nitroglycerin prior to admission to our hospital. However, the patient's symptoms deteriorated. An enhanced computed tomography scan revealed a ruptured 25-mm diameter mediastinal aneurysm under the tracheal bifurcation when he was admitted to our hospital. Bronchial arteriography further demonstrated a ruptured mediastinal BAA of a bronchial artery originated from the left subclavian artery, supplying the right lobe. Transcatheter artery embolization with polyvinyl alcohol particles and microcoils was performed successfully. The patient's symptoms were gradually relieved, and without recurrence on 1 year follow-up.This case highlights the rare variation of mediastinal BAA and the role of interventional radiology in diagnosing and treating this critical condition.

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Bronchial artery pseudoaneurysm with symptomatic mediastinal hematoma

Cited by 18 publications

References 12 publications

A Rare Case of Ruptured Bronchial Artery Pseudoaneurysm and Its Nonsurgical Management With Interventional Techniques

A Rare Case of Ruptured Bronchial Artery Pseudoaneurysm and Its Nonsurgical Management With Interventional Techniques

Bronchial Artery Pseudoaneurysm With Major Hemorrhage After Bronchial Thermoplasty

Percutaneous Embolization for Ruptured Ectopic Bronchial Artery Aneurysm

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