Usefulness of Thoracic Endovascular Aortic Repair for the Treatment of Massive Hemoptysis due to Bronchial Tuberculosis

Abstract

We report a case of a 64-year-old man who obtained effective hemostasis with thoracic endovascular aortic repair (TEVAR) for massive hemoptysis due to bronchial tuberculosis. The patient presented to our hospital with massive hemoptysis. Contrast-enhanced computed tomography (CT) showed dilation of the right bronchial artery and obstruction of the right bronchus from the middle trunk due to hematoma, and sputum mycobacterial culture revealed M. tuberculosis, which led to the diagnosis of massive hemoptysis from the right bronchial artery by bronchial tuberculosis. Emergency bronchial artery embolization (BAE) was performed, but was discontinued due to a localized aortic dissection during the operation. Although respiratory management was started by separate lung ventilation, veno-venous Extra-corporeal Membrane Oxygenation (VV-ECMO) was introduced due to a rapid desaturation, and TEVAR was urgently performed for hemostasis. The patient passed the post-operative period without any clinically significant hemoptysis, and was discharged 47 days after the TEVAR.