case_images: PMC11402734_01
case_images: Bronchial arteriography before and after BAE. (A) A fistula between the right bronchial artery and pulmonary artery. (B) A fistula between the subclavian artery and pulmonary artery. (C) An atypical fistula, originating from the arcus aortae, between the right bronchial artery and pulmonary artery, featuring multiple tortuous and dilated branches with distal vascular beds. (D-F) The coil successfully embolized the target vessel and the bronchial artery-pulmonary artery fistula was occluded after BAE.
case_images: fcvm-11-1456360-g001.jpg
case_images: PMC11402734_01_fcvm-11-1456360-g001.jpg
case_images: F1
case_images: Bronchial angiography identified multiple anastomoses between the hypertrophic bronchial arteries and the right subsegmental pulmonary artery (Figure 1), without filling defects in the pulmonary artery, as confirmed by pulmonary angiography (Figure 2A). Two typical fistulas, originating from the right bronchial artery (Figure 1A) and the subclavian artery (Figure 1B), were identified and successfully embolized with coils (Figures 1D,E). Another atypical fistula, arising from the aortic arch, between the right bronchial artery and the pulmonary artery was initially misdiagnosed due to tortuosity, dilation, and hyperplasia at the vessel end (Figure 1C). Coils were subsequently used to embolize the culprit bronchial arteries (Figure 1F).
case_images: Pulmonary angiography before and after BAE. (A) There was no filling defect in the pulmonary artery before BAE. (B) Filling defects in the right subsegmental pulmonary artery after BAE were confirmed. (C) Restoration of pulmonary perfusion after percutaneous catheter-directed embolectomy.
case_images: fcvm-11-1456360-g002.jpg
case_images: PMC11402734_01_fcvm-11-1456360-g002.jpg
case_images: F2
case_images: Bronchial angiography identified multiple anastomoses between the hypertrophic bronchial arteries and the right subsegmental pulmonary artery (Figure 1), without filling defects in the pulmonary artery, as confirmed by pulmonary angiography (Figure 2A). Considering the possibility of an ectopic embolism due to particle translocation, selective pulmonary angiography confirmed filling defects in the right lower lobe (Figure 2B). Postoperative pulmonary angiography demonstrated restoration of pulmonary perfusion (Figure 2C).
case_images: Percutaneous catheter-directed embolectomy. (A) The granular beaded material and thrombus mixture was aspirated in surgery. (B) Histological examination confirmed the presence of a mixed thrombus with scattered refractive, round-like, or patchy particles.
case_images: fcvm-11-1456360-g003.jpg
case_images: PMC11402734_01_fcvm-11-1456360-g003.jpg
case_images: F3
case_images: The granular beaded material and thrombus mixture was removed (Figure 3A). Histological examination confirmed a mixed thrombus with scattered refractive, round-like, or patchy particles (Figure 3B).