Coil embolization of a bronchial artery aneurysm originating from the false lumen prior complex endovascular repair for type II postdissection thoracoabdominal aneurysm

TL;DR

A rare case of a bronchial artery aneurysm is successfully treated with coil embolization followed by aortic repair.

Contribution

Presents a novel staged treatment approach for a complex bronchial artery aneurysm following aortic dissection.

Findings

Endovascular coil embolization successfully excluded the bronchial artery aneurysm.

A staged approach combining embolization and open repair was effective with no complications.

Multidisciplinary strategies are crucial for managing complex aortic and bronchial artery pathologies.

Abstract

Bronchial artery aneurysm (BrAA) is a rare but potentially life-threatening condition, often associated with aortic pathology. We present a case of a 59-year-old man with a history of Stanford type A acute aortic dissection and subsequent aortic repairs. Surveillance imaging revealed a progressively enlarging right-sided BrAA originating from the false lumen. A staged approach was adopted, beginning with endovascular coil embolization using 18 detachable coils, followed by an open aortic repair. The procedure was successful, with complete aneurysm exclusion and no perioperative complications. This case underscores the technical challenges of BrAA embolization and highlights the efficacy of a multidisciplinary, staged treatment strategy.