-Case Reports-

Two Cases of Bronchial Artery Racemose Hemangioma Successfully Treated with Bronchial Artery Embolization

Natsuki Hashiba¹, Ryuta Nakae¹, Daisuke Yasui², Masaaki Inoue¹, Riko Maejima¹, Toru Takiguchi¹, Hidetaka Onda¹, Shiei Kim¹ and Shoji Yokobori¹

¹Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
²Department of Radiology, Nippon Medical School, Tokyo, Japan

Rupture of a racemose hemangioma causing dilatation and tortuosity of the bronchial artery can result in massive bleeding and respiratory failure. Bronchial artery embolization (BAE) can treat this life-threatening condition, as we show in two cases. The first case was of an 89-year-old female complaining of sudden-onset chest and back pain. Bronchial artery angiography demonstrated a racemose hemangioma with a 2 cm aneurysm. The second case was of a 50-year-old male with hemoptysis and dyspnea, eventually requiring intubation. Bronchial arteriography showed a racemose hemangioma and a bronchial artery-pulmonary arterial fistula. BAE was successfully performed in both cases, with no recurrent hemorrhage. Therapeutic interventions in bronchial artery racemose hemangiomas include lobectomy or segmentectomy, bronchial arterial ligation, and BAE. BAE should be considered as first-line therapy for bleeding racemose hemangiomas of the bronchial artery because of its low risk of adverse effects on respiratory status, minimal invasiveness, and faster patient recovery.

J Nippon Med Sch 2022; 89: 594-598

Keywords
cardiovascular abnormalities, bronchial arteries, radiology, interventional, embolization

Correspondence to
Natsuki Hashiba, MD, Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
n-hashiba@nms.ac.jp

Received, April 28, 2021
Accepted, August 4, 2021