# Proximal interruption of the pulmonary artery with systemic bronchial/intercostal aneurysm formation: a case report

## TL;DR

A rare case of a 67-year-old woman with a blocked pulmonary artery was successfully treated with a less invasive procedure instead of surgery.

## Contribution

Demonstrates bronchial artery embolisation as a viable first-line treatment for PIPA, avoiding major surgery.

## Key findings

- PIPA was diagnosed through imaging showing a small pulmonary artery and collateral vessels.
- Bronchial artery embolisation was performed in two stages and prevented further bleeding.
- The patient remained free of haemoptysis for 13 months post-treatment.

## Abstract

Proximal Interruption of the Pulmonary Artery (PIPA) is a rare congenital condition with an incidence of 1 in 200,000–300,000 individuals. We report the case of a 67-year-old woman with PIPA who presented with massive haemoptysis. Imaging revealed a small calibre right main pulmonary artery, absence of upper/middle lobe pulmonary arteries, and tortuous right systemic collateral arteries. A multidisciplinary meeting favoured bronchial artery embolisation over right pneumonectomy, due to the bleeding risk associated with extensive transpleural systemic collateral arteries. The patient underwent two staged bronchial artery embolisation and remained free of haemoptysis at the most recent 13-month follow-up. This case highlights the potential for bronchial artery embolisation to serve as a first-line treatment in managing PIPA, as a less invasive alternative to surgery.