Related Experiment Video
Updated: Jul 10, 2026
Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
Published on: August 26, 2025
Endovascular Management of Interlobolar Bronchopulmonary Arterial Fistula After Bronchial Stent Removal
Anand Mulji1, Michael Sagatelian2, Madeline Leo1
1Division of Vascular Interventional Radiology, Medical University of South Carolina, Charleston, South Carolina, USA.
Background:
Bronchopulmonary arterial fistulas are rare, life-threatening causes of hemoptysis, often occurring in patients with thoracic malignancy, radiation exposure, or repeated airway instrumentation.
Case Summary:
A 36-year-old woman with metastatic epithelioid sarcoma and radiation-induced bronchus intermedius stenosis underwent multiple bronchoscopic dilations and airway stent placements. Following bronchial stent removal, she developed massive airway hemorrhage. Computed tomography angiography demonstrated bronchopulmonary arterial fistula. Given prohibitive surgical risk, endovascular exclusion with a covered pulmonary arterial stent achieved immediate hemostasis. Recurrent hemoptysis due to incomplete stent apposition was successfully treated with repeat angioplasty. The patient remained clinically stable on follow-up.
Discussion:
Successful endovascular management of bronchovascular fistulas offers effective hemorrhage control while preserving pulmonary perfusion in nonsurgical candidates.
Take-Home Messages:
Endovascular therapy can serve as a salvage option for bronchopulmonary arterial fistulas in high-risk patients. Multidisciplinary coordination, postprocedural surveillance, and lifelong prophylaxis are essential for durable outcomes.
