胸部大動脈ステントグラフトを併用した塞栓術が有効であった無症候性気管支動脈瘤

Successful Treatment with Aortic Stent Graft and Transcatheter Embolization for Bronchial Artery Aneurysm

気管支動脈瘤はまれな疾患であり，破裂すると致死的出血となるため，大きさにかかわらず診断次第，外科的治療もしくは血管内治療が行われる．近年では低侵襲性から血管内治療が第一選択となり気管支動脈塞栓術が広く行われているが，再疎通や塞栓完遂性の問題がある．われわれは，気管支動脈瘤に対して気管支動脈塞栓術および胸部大動脈ステントグラフト内挿術（TEVAR）が有用であった症例を経験したので報告する．

We report a case of bronchial artery aneurysm （BAA） successfully treated with a combination of transcatheter embolization and stent graft. A 50-year-old woman was referred to our hospital for further examination of a hemispherical bulging lesion on the middle esophagus detected by gastroscopy. Computed tomography （CT） revealed BAA with a 15 mm-diameter arising from the descending aorta on the left side of the esophagus. We performed transcatheter embolization combined with a stent graft because of a short neck. Postoperative course was uneventful. Follow-up CT showed complete isolation of the blood flow into the BAA. BAA is rare and often found incidentally by diagnostic imaging as shown in our case. Prompt treatment with complete isolation of blood inflow is required because the rupture of BAA is life-threatening.