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支气管动脉瘤罕见病例及真性支气管动脉瘤与假性支气管动脉瘤介入栓塞治疗的比较

Rare Cases of Bronchial Aneurysm and Comparison of Interventional Embolization in the Treatment of True Bronchial Aneurysm and Pseudobronchial Aneurysm.

作者信息

Lin Jia-Li, Ji Yuan-Yuan, Zhang Ming-Zhe, Tang Yi, Wang Ruo-Li, Ruan Dan-Dan, Zhou Yan-Feng, Wu Shao-Jie, Cai Sen-Lin, Zhang Jian-Hui, Meng Xiao-Rong, Luo Jie-Wei, Fang Zhu-Ting

机构信息

Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.

Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China.

出版信息

Front Cardiovasc Med. 2022 Mar 9;9:856684. doi: 10.3389/fcvm.2022.856684. eCollection 2022.

Abstract

BACKGROUND

Bronchial artery aneurysm (BAA) is a rare disease. Rupture of BAA can lead to life-threatening hemoptysis, and once diagnosed, treatment is needed regardless of symptoms. Transcatheter artery embolization is the first choice of treatment because it is minimally invasive and effective. This study aimed to retrospectively compare the embolization treatment of a case of true BAA and that of a pseudobranchial aneurysm and explore the choice of embolization method for BAA with short neck or no neck.

MATERIALS AND METHODS

Embolization treatment and imaging characteristics of one case of true BAA and one case of pseudobronchial aneurysm admitted to our hospital were analyzed retrospectively. Embolization methods and therapeutic effects of two cases of BAAs were compared.

RESULTS

Case 1 was that of an intact true BAA inside the mediastinum located at the opening of the bronchial artery. The distal end of the aneurysm was embolized, and tumor cavity was occluded. No recurrence of BAA was found after the operation. Case 2 was that of a ruptured and hemorrhagic pseudobronchial aneurysm of the mediastinum. Coil embolization combined with covered stent graft exclusion of the thoracic aorta were performed, and the left bronchial artery and BAA were almost occluded. Nine months postoperatively, the mediastinal hematoma was almost completely absorbed.

CONCLUSION

Endovascular embolization has become the most commonly used for the treatment of BAA. Different methods should be selected according to the location and nature of the aneurysm.

摘要

背景

支气管动脉动脉瘤(BAA)是一种罕见疾病。BAA破裂可导致危及生命的咯血,一旦确诊,无论有无症状均需治疗。经导管动脉栓塞术因其微创且有效,是首选的治疗方法。本研究旨在回顾性比较1例真性BAA与1例假性支气管动脉瘤的栓塞治疗情况,并探讨颈部短或无颈部的BAA的栓塞方法选择。

材料与方法

回顾性分析我院收治的1例真性BAA和1例假性支气管动脉瘤的栓塞治疗及影像学特征。比较2例BAA的栓塞方法及治疗效果。

结果

病例1为位于支气管动脉开口处纵隔内完整的真性BAA。对动脉瘤远端进行栓塞,并闭塞瘤腔。术后未发现BAA复发。病例2为纵隔破裂出血性假性支气管动脉瘤。采用弹簧圈栓塞联合带膜支架隔绝胸主动脉,左支气管动脉及BAA几乎闭塞。术后9个月,纵隔血肿几乎完全吸收。

结论

血管内栓塞已成为治疗BAA最常用的方法。应根据动脉瘤的位置和性质选择不同的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/964c/8959610/c072feb282a9/fcvm-09-856684-g001.jpg

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