Copping R, Ng N, Osman S
Interventional Radiology Department, Liverpool Hospital, New South Wales, Australia.
UNSW Medicine and Health, South West Sydney Clinical Campuses, University of New South Wales, Sydney, Australia.
CVIR Endovasc. 2024 Aug 14;7(1):62. doi: 10.1186/s42155-024-00474-2.
Bronchial artery pseudoaneurysms (BAP) or aneurysms (BAA) are rare, potentially life-threatening and remain poorly understood. They are most commonly idiopathic but may be associated with a number of other disease processes. Bronchial artery embolisation (BAE) is considered the first line treatment while surgical techniques are reserved for patients with a clear contraindication to embolisation or where anatomical factors preclude an endovascular approach.
We present an interesting case of a 56 year-old male presenting with an idiopathic unruptured right BAP causing clinical and radiological signs of left recurrent laryngeal nerve (RLN) palsy. He was otherwise clinically well with no other reported symptoms and no significant past medical history. There were no significant findings on work-up and investigation. He was ultimately treated successfully with selective transarterial coil embolization of the right bronchial artery. This is an atypical presentation of a rare clinical entity and has not previously been published in the literature to our knowledge.
BAPs and BAAs are highly variable in their presentation, ranging from incidental asymptomatic findings to catastrophic haemorrhage, depending on their location and if they are contained or ruptured. Timely diagnosis and referral to facilitate urgent embolisation is essential to prevent potentially serious clinical sequelae. Endovascular treatment in the form of BAE is considered first line.
支气管动脉假性动脉瘤（BAP）或动脉瘤（BAA）较为罕见，有潜在生命危险，目前仍了解不足。它们最常见的病因是特发性的，但也可能与许多其他疾病过程相关。支气管动脉栓塞术（BAE）被视为一线治疗方法，而手术技术则适用于有明确栓塞禁忌证或解剖因素排除血管内治疗途径的患者。
我们报告了一例有趣的病例，一名56岁男性，患有特发性未破裂的右BAP，导致左侧喉返神经（RLN）麻痹的临床和影像学表现。除此之外，他临床状况良好，无其他报告症状，既往病史无显著异常。检查和调查未发现重大异常。他最终通过选择性经动脉线圈栓塞右支气管动脉成功治疗。这是一种罕见临床实体的非典型表现，据我们所知，此前文献中尚未发表过。
BAP和BAA的表现高度多变，从偶然的无症状发现到灾难性出血不等，这取决于它们的位置以及是否局限或破裂。及时诊断并转诊以促进紧急栓塞对于预防潜在的严重临床后遗症至关重要。以BAE形式进行的血管内治疗被视为一线治疗方法。
