case_images: PMC10801073_01
case_images: Diagnostic images of the patient with BAA. (A) The CT scan image of the chest shows an abnormally enhanced lesion in the mediastinum and dilated bronchial arteries near the descending aorta, but no entrapment or hemopneumothorax. (B) Three-dimensional reconstruction of the CT angiographic model shows a 25-mm-diameter BAA from the descending aorta with a dilated and tortuous inflow vessel. (C) Selective bronchial arteriography shows that the aneurysm was fed by a bronchial artery dilated by the descending aorta.
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case_images: PMC10801073_01_fcvm-10-1328674-g001.jpg
case_images: F1
case_images: The suspicion of an aneurysm was first raised by an abnormal enhancement of a mediastinal lesion on a contrast-enhanced computed tomography (CT) scan of the chest (Figure 1A). The subsequent three-dimensional reconstruction of the CT angiogram showed a BAA with a 25-mm diameter and a dilated and tortuous inflow vessel from the right bronchial artery trunk (Figure 1B), which together with an aortic arch angiogram confirmed this diagnosis (Figure 1C).
case_images: Angiogram during catheter intervention. Intraoperative angiography of the BAA shows that the catheter failed to enter the aneurysm due to tortuous arteries.
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case_images: PMC10801073_01_fcvm-10-1328674-g002.jpg
case_images: F2
case_images: However, due to the tortuosity of the inflow vessel, it was challenging to advance into the outflow vessel using a microcatheter (MC-PE28131, Terumo, Tokyo, Japan) and a 0.018-inch micro-guidewire (Figure 2).
case_images: Patient's follow-up examination pictures after 1 year of treatment. (A) CT angiography was performed on the patient 1 year after treatment, and the scan suggests the presence of metallic artifacts from coils within the BAA. (B) Three-dimensional reconstruction of the vessel based on the CT angiography data shows no rupture of the BAA and no new collateral arteries supplying the BAA.
case_images: fcvm-10-1328674-g003.jpg
case_images: PMC10801073_01_fcvm-10-1328674-g003.jpg
case_images: F3
case_images: Follow-up after 1 year, utilizing CT angiography and three-dimensional aorta reconstruction, revealed an absence of contrast filling in the BAA, indicating a positive prognosis during the 1-year follow-up (Figure 3).
case_images: Timeline of treatment and follow-up.
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case_images: PMC10801073_01_fcvm-10-1328674-g004.jpg
case_images: F4