A Stepwise Embolization Strategy for a Bronchial Arterial Aneurysm: Proximal Coil and Distal Glue with the Optional Use of a Microballoon Occlusion System

作者：Mine Takahiko^*; Matsumoto Tomohiro; Hayashi Toshihiko; Tomita Kosuke; Masuda Kimihiko; Kawashima Masahiro; Sakamaki Fumio; Hasebe Terumitsu

来源：CardioVascular and Interventional Radiology, 2018, 41(8): 1267-1273.

DOI：10.1007/s00270-018-1969-1

• Bronchial arterial aneurysm
• Hemoptysis
• Bronchial arterial embolization
• n-Butyl cyanoacrylate
• Detachable coil

This study aimed to demonstrate a transcatheter embolization strategy for bronchial artery aneurysms (BAAs) using coils for the proximal lesion and glue (n-butyl-2-cyanoacrylate [NBCA]) embolization for the distal lesion with or without the use of a microballoon occlusion catheter.
Five patients with BAAs presenting with hemoptysis were enrolled in this study. A bronchial angiogram indicated a mediastinal BAA near the orifice, accompanied by dilated distal branches with or without intrapulmonary BAA. A stepwise procedure was performed. First, the intrapulmonary branches were embolized with glue, with or without the use of a microballoon catheter depending upon the anatomical and local flow hemodynamic conditions. Second, the mediastinal BAA was tightly packed with detachable coils.
Glue embolization of intrapulmonary abnormal branches successfully controlled hemoptysis in all patients; microballoon catheters were used in five of the 10 arteries. The volume embolization ratio of coils within the mediastinal BAA ranged from 28 to 59%, and neither coil compaction nor signs of recanalization were observed during follow-up.
The stepwise embolization procedure with the sequential use of glue (with or without a microballoon occlusion system) and detachable coils may represent a possible endovascular strategy for the treatment of complex BAAs.
Level 4: Case Series.

• 出版日期2018-8