Bronchial arterial aneurysms

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Bronchial arterial aneurysm refers to any form of aneurysmal dilatation involving any segment of the bronchial artery. The term is sometimes used synonymously with a bronchial arterial pseudoaneurysm .

Epidemiology

They are a rare entity and are reported in <1% of those who undergo selective bronchial arterial angiograms .

Clinical presentation

Most patients are asymptomatic until they rupture. A large mediastinal aneurysm may present as a mediastinal mass, acute superior vena cava obstruction or dysphagia .

Pathology

Their exact pathogenesis is not well known. Most cases have been reported in patients with the following background conditions:

silicosis
bronchiectasis
lung cancer
recurrent infection
thoracic trauma
Rendu-Osler-Weber syndrome

Bronchial artery aneurysms have also been found in individuals with predisposing congenital conditions and systemic vascular diseases such as cystic fibrosis and atherosclerosis. In patients without predisposing pulmonary or systemic disease, bronchial artery aneurysms are extremely rare.

Location

They can be mediastinal (juxta-aortic) or intrapulmonary.

Treatment and prognosis

The treatment options for bronchial artery aneurysm include transcatheter embolization, placement of a covered stent, and surgery.

Complications

Catastrophic hemorrhage is is one of the most feared complications.