Alone Thoracic Endovascular Aneurysm Repair for Bronchial Artery Aneurysm: A Long-term Follow Up Case

Abstract

Bronchial artery aneurysms are rare, presenting in less than 1% of selective bronchial arteriography. The risk of rupture is high regardless of the size of the aneurysm, and treatment is necessary as soon as it is diagnosed, even if the patient is asymptomatic. A 78-year-old woman presented with chief complain of coughing. Computed tomography (CT) showed a bronchial artery aneurysm with a diameter of 25 mm, so we opted for treatment with thoracic endovascular aneurysm repair (TEVAR). Although we attempted to embolize the outflow vessel, the inflow vessel was too thin to cannulate, so we decided to close the inflow vessel with TEVAR alone. The postoperative course was uneventful. Enhanced CT on postoperative day 7 showed no endoleak, and the aneurysm was thrombosed. Follow-up CT showed that the aneurysm gradually shrank to 14 mm in diameter at 4 years postoperatively and had remained at the same diameter at 11 years. In the endovascular treatment of bronchial artery aneurysms, a combination of embolization of the outflow vessel and closure of the inflow vessel with TEVAR can be a more reliable strategy. Even when embolization of the outflow vessel is difficult, TEVAR alone may provide a good long-term outcome.