PMC5288960_01
A 63-year-old woman without significant medical history who presented with subacute onset of dyspnea on exertion. (a) Computed tomography pulmonary angiogram highlights the pulmonary arteries; there is a note of a nonspecific infrahilar mass (white arrow). (b) Repeat computed tomography arteriogram allows tracing of bronchial artery (black arrows). Previously noted infrahilar mass is highlighted suggesting bronchial artery aneurysm.
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F1
A computed tomography (CT) pulmonary angiogram was significant for a single 1.2 cm right infrahilar nonspecific density that was suspicious for an arterial source [Figure 1a]. BAA [Figure 1b]. Bronchial artery angiography was then performed, further demonstrating the presence of a BAA with BA-PA fistula [Figure 2a and b].
A 63-year-old woman without significant medical history who presented with subacute onset of dyspnea on exertion. (a) Bronchial artery angiogram with contrast injected directly into the bronchial artery under video fluoroscopy shows contrast filling of the bronchial artery aneurysm (black arrow) and simultaneous filling of the pulmonary artery (white arrow). On video fluoroscopy, contrast was noted to flow outward toward the lung periphery. (b) Bronchial artery angiogram after slight time delay shows contrast fading from pulmonary artery (white arrow) and flowing inward toward the hila through pulmonary vein (black arrow). This was, therefore, consistent with bronchial artery to pulmonary artery fistula rather than bronchial artery to pulmonary artery fistula.
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F2
BAA [Figure 1b]. Bronchial artery angiography was then performed, further demonstrating the presence of a BAA with BA-PA fistula [Figure 2a and b].
A 63-year-old woman without significant medical history who presented with subacute onset of dyspnea on exertion. Successful postembolization bronchial artery angiogram shows cyanoacrylate glue outlining and occluding the distal bronchial artery (black arrow).
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F3
The patient underwent successful embolization of with cyanoacrylate [Figure 3].
A 63-year-old woman without significant medical history who presented with subacute onset of dyspnea on exertion. One-year status-postembolization follow-up, computed tomography angiogram confirming durable bronchial artery occlusion (white arrows) without notable expansion of bronchial artery aneurysm.
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F4
During her 1-year postembolization follow-up, the patient remained stable with improvement of her dyspnea, and CT angiogram confirming durable bronchial artery occlusion without notable expansion of the BAA [Figure 4].