Two Cases of Bronchial Artery Racemose Hemangioma Successfully Treated with Bronchial Artery Embolization

Abstract

Rupture of a racemose hemangioma causing dilatation and tortuosity of the bronchial artery can result in massive bleeding and respiratory failure. Bronchial artery embolization (BAE) can treat this life-threatening condition, as we show in two cases.The first case was of an 89-year-old female complaining of sudden-onset chest and back pain. Bronchial artery angiography demonstrated a racemose hemangioma with a 2 cm aneurysm. The second case was of a 50-year-old male with hemoptysis and dyspnea, eventually requiring intubation. Bronchial arteriography showed a racemose hemangioma and a bronchial artery-pulmonary arterial fistula. BAE was successfully performed in both cases, with no recurrent hemorrhage. Therapeutic interventions in bronchial artery racemose hemangiomas include lobectomy or segmentectomy, bronchial arterial ligation, and BAE. BAE should be considered as first-line therapy for bleeding racemose hemangiomas of the bronchial artery because of its low risk of adverse effects on respiratory status, minimal invasiveness, and faster patient recovery.

Endovascular treatment for massive haemoptysis due to pulmonary pseudoaneurysm: report of 23 cases

“…A BA-PA and/or NBSA-PA fistula may be caused by pulmonary and pleural infection, pneumothorax, malignant tumour, or chest trauma leading to pulmonary hypertension [ 25 – 27 ]. Our results indicate that BA and/or NBSA-PA fistulas significantly increase PA pressure because the pressures and velocities of the BA and NBSA supplied by the systemic circulation are higher than those of the pulmonary artery [ 28 , 29 ]. However, the fistula disappeared after embolization, and the PA pressure decreased.…”

A case of primary racemose hemangioma with endobronchial lesions demonstrating recurrent hemoptysis initially treated with bronchial arterial embolization

“…We reviewed the literature of similar cases where BAE was performed for RHBA since 2000, and extracted the following information: age, sex, chief complaint, location of bleeding point, endoscopic findings, and treatment to control bleeding [ 3 , 5 , 7 , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] ]. As a result, there were 16 cases of RHBA in 14 reports including the case presented in this report ( Table 1 ).…”