A Case of Ruptured Mediastinal Bronchial Artery Aneurysm Successfully Treated with Artery Embolization with N-butyl-2-cyanoacrylate and a Coil

Abstract

Background. Bronchial artery aneurysm is a rare disease but can be life-threatening when it ruptures. Case. A 74-year-old woman with hypertention presented with sudden back pain at dinner and visited our emergency department. Contrast-enhanced computed tomography showed an enlargement of the middle mediastinum and a high-density 6-mm nodule connected to the bronchial artery in the early phase. After the examination, her systolic blood pressure dropped to about 40 mmHg. Emergency bronchial artery angiography showed a bronchial artery aneurysm, so artery embolization with N-butyl-2-cyanoacrylate (NBCA) /lipiodol and a microcoil was performed, which succeeded. Her post-procedure course was uneventful, and she was discharged on the 16^th day of admission. There has been no recurrence in the 1 year and 5 months since the procedure. Conclusion. Ruptured bronchial artery aneurysm should be diagnosed early. Artery embolization is effective for the treatment, and NBCA is useful as an embolic material.