Hashiba Natsuki, Nakae Ryuta, Yasui Daisuke, Inoue Masaaki, Maejima Riko, Takiguchi Toru, Onda Hidetaka, Kim Shiei, Yokobori Shoji
Department of Emergency and Critical Care Medicine, Nippon Medical School.
Department of Radiology, Nippon Medical School.
J Nippon Med Sch. 2023 Feb 1;89(6):594-598. doi: 10.1272/jnms.JNMS.2022_89-601. Epub 2021 Nov 26.
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.
蔓状血管瘤破裂导致支气管动脉扩张和迂曲可引起大出血和呼吸衰竭。正如我们在两个病例中所展示的，支气管动脉栓塞术（BAE）可以治疗这种危及生命的状况。第一例是一名89岁女性，主诉突发胸痛和背痛。支气管动脉血管造影显示一个2厘米动脉瘤的蔓状血管瘤。第二例是一名50岁男性，有咯血和呼吸困难，最终需要插管。支气管动脉造影显示一个蔓状血管瘤和一个支气管动脉 - 肺动脉瘘。两例均成功进行了BAE，无复发出血。支气管动脉蔓状血管瘤的治疗干预措施包括肺叶切除术或肺段切除术、支气管动脉结扎术和BAE。由于BAE对呼吸状态的不良反应风险低、微创性以及患者恢复较快，应将其视为支气管动脉出血性蔓状血管瘤的一线治疗方法。
