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Thoracoscopic Bronchial Artery Resection for Multiple Bronchial Artery Aneurysms
Haruhiko Shiiya1, Yasuhiro Suzuki2, Shigeo Yamazaki2
1Department of Cardiovascular and Thoracic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
Summary
A minimally invasive thoracoscopic bronchial artery resection successfully treated multiple bronchial artery aneurysms and a fistula in an asymptomatic patient. This approach offered a viable alternative to catheter embolization for complex vascular anomalies.
Area of Science:
- Vascular Surgery
- Thoracic Surgery
- Interventional Radiology
Background:
- Bronchial artery aneurysms (BAAs) and arteriovenous fistulas are rare but can lead to significant complications.
- Traditional treatment often involves catheter-based embolization, which may not always be feasible or effective for complex anatomy.
Observation:
- A 36-year-old asymptomatic female presented with multiple BAAs and a bronchial artery (BA) to pulmonary artery (PA) fistula.
- Three-dimensional computed tomography (3DCT) provided detailed visualization of the BA anatomy and aneurysm locations.
- Preoperative BA angiography clearly delineated the BA-PA fistula, aiding surgical planning.
Findings:
- The patient underwent successful thoracoscopic BA resection without lobectomy as a first-line treatment.
- Preoperative imaging guided the precise identification and resection of the affected BA segment, ensuring complete removal of all BAAs.
- This minimally invasive surgical approach was chosen over catheter embolization.
Implications:
- Thoracoscopic BA resection is a safe and effective alternative to catheter embolization for complex BAAs and fistulas.
- Advanced imaging techniques like 3DCT and angiography are crucial for preoperative planning and successful surgical outcomes.
- This case highlights the importance of tailored surgical strategies for managing rare thoracic vascular abnormalities.
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