PDF(Pubmed)
Abstract：
BACKGROUND: Bronchial artery aneurysm (BAA) is a rare vascular anomaly with the potential for serious complications, such as rupture leading to hemothorax or hemoptysis. Although bronchial artery embolization (BAE) is recognized as an effective intervention for ruptured BAA, video-assisted thoracoscopic surgery (VATS) is a minimally invasive approach for the treatment of associated hemothorax.
METHODS: A 73-year-old woman presented with a mediastinal hematoma from a ruptured BAA, causing bilateral hemothorax. Emergency angiography revealed a saccular BAA that was successfully embolized using a microcatheter and coil. Subsequent computed tomography revealed an expanding hemothorax managed by VATS, with 1400 mL of blood drained. During VATS, thoracoscopy revealed pulmonary ligament rupture, which was attributed to increased intramediastinal pressure. The patient was discharged eight days postoperatively with no complications. This case highlights the use of BAE and VATS in the management of mediastinal BAA rupture and massive hemothorax.
CONCLUSIONS: BAE proved to be an effective strategy for the management of ruptured mediastinal BAAs. VATS is a valuable standby procedure for hematoma removal, but the indication should be carefully determined because of the risk of BAA re-rupture.
METHODS: A 73-year-old woman presented with a mediastinal hematoma from a ruptured BAA, causing bilateral hemothorax. Emergency angiography revealed a saccular BAA that was successfully embolized using a microcatheter and coil. Subsequent computed tomography revealed an expanding hemothorax managed by VATS, with 1400 mL of blood drained. During VATS, thoracoscopy revealed pulmonary ligament rupture, which was attributed to increased intramediastinal pressure. The patient was discharged eight days postoperatively with no complications. This case highlights the use of BAE and VATS in the management of mediastinal BAA rupture and massive hemothorax.
CONCLUSIONS: BAE proved to be an effective strategy for the management of ruptured mediastinal BAAs. VATS is a valuable standby procedure for hematoma removal, but the indication should be carefully determined because of the risk of BAA re-rupture.
摘要：
背景：支气管动脉瘤（BAA）是一种罕见的血管异常，有可能导致严重的并发症，如破裂导致血胸或咯血。尽管支气管动脉栓塞（BAE）被认为是BAA破裂的有效干预措施，电视胸腔镜手术(VATS)是治疗相关血胸的一种微创方法.
方法：一名73岁的女性因BAA破裂而出现纵隔血肿，引起双侧血胸.紧急血管造影显示，使用微导管和线圈成功栓塞了囊状BAA。随后的计算机断层扫描显示由VATS管理的不断扩大的血胸，排出1400毫升的血液。在VATS期间,胸腔镜检查显示肺韧带破裂，这归因于血管内压力增加。患者术后8天出院，无并发症。该病例强调了BAE和VATS在纵隔BAA破裂和大量血胸的治疗中的应用。
结论：BAE被证明是治疗纵隔BAA破裂的有效策略。VATS是清除血肿的宝贵备用程序，但由于BAA再破裂的风险，应仔细确定适应症。
方法：一名73岁的女性因BAA破裂而出现纵隔血肿，引起双侧血胸.紧急血管造影显示，使用微导管和线圈成功栓塞了囊状BAA。随后的计算机断层扫描显示由VATS管理的不断扩大的血胸，排出1400毫升的血液。在VATS期间,胸腔镜检查显示肺韧带破裂，这归因于血管内压力增加。患者术后8天出院，无并发症。该病例强调了BAE和VATS在纵隔BAA破裂和大量血胸的治疗中的应用。
结论：BAE被证明是治疗纵隔BAA破裂的有效策略。VATS是清除血肿的宝贵备用程序，但由于BAA再破裂的风险，应仔细确定适应症。
