Isolated giant true intercostal artery aneurysm with arteriovenous fistula: A case report

Objectives Intercostal artery aneurysm (IAA) is a very rare condition. Interestingly, only one study reported a case of intercostal aneurysm caused by an arteriovenous fistula (AVF). Here, we report the case of a patient with non-ruptured isolated giant true IAA caused by an AVF (size, 28 × 41 mm). Methods Treatment options for IAA include open surgery and endovascular treatment (EVT). We chose EVT, as it is minimally invasive. The right 11th intercostal artery and aneurysm diverged from the aorta. Two outflow arteries, one inflow artery, and an AVF from the aneurysm were confirmed, and coil embolization was performed. The artery of Adamkiewicz did not communicate with the right 11th intercostal artery. We performed angiography and confirmed occlusion of IAA with endoleak. Results There were no clinical findings indicative of spinal cord infarction after treatment. The patient did not develop complications and was discharged the day after treatment. Endoleak was not observed on computed tomography angiography findings at 1 month after treatment. Conclusions In our patient, an AVF might have caused IAA. Endovascular treatment for non-ruptured isolated giant IAA is a safe and minimally-invasive treatment. We found that performing EVT is beneficial when the size of the IAA exceeds 30 mm.

Successful Of Embolization Therapy On Recurrent Massive Hemoptysis because of TB Sequelae

Background: Haemoptysis is one of vascular lesions in TB sequelae, with incidence of 28% from 919 cases. It may be recurrent, massive and might cause mortality if left untreated. Embolization procedure with glue and coil can be an alternative to treat patient with recurrent hemoptysis. Case Report: We reported a case report in Saiful Anwar Malang Hospital, Indonesia, a 34 years old male with intermittent massive haemoptysis. Chest X-ray examination showed Lung Tb far advanced lesion with no acid bacilli found on microbiological examination. Transthoracic FNAB revealed chronic suppurative inflammation, with Cytology sputum Class II. Chest CT Angiography showed Lung TB Far advanced lesions accompanied by mediastinal lymphadenopathy with unsuspecting complications of left supreme intercostal artery aneurysm dd pseudoaneurysm, suggestion embolization. Examination results confirmed the diagnosis of recurrent massive haemoptysis and intercostal artery aneurysm with the history of TB. Embolization procedure was then performed. Conclusion: Angiography CT Scan has better detail in evaluating condition, source, amount, and tract of artery in chest cavity. Bronchial artery embolization as an alternative therapy was found to give better effect of occlusion.

Successful Of Embolization Therapy On Recurrent Massive Hemoptysis because of TB Sequelae

Background: Haemoptysis is one of vascular lesions in TB sequelae, with incidence of 28% from 919 cases. It may be recurrent, massive and might cause mortality if left untreated. Embolization procedure with glue and coil can be an alternative to treat patient with recurrent hemoptysis. Case Report: We reported a case report in Saiful Anwar Malang Hospital, Indonesia, a 34 years old male with intermittent massive haemoptysis. Chest X-ray examination showed Lung Tb far advanced lesion with no acid bacilli found on microbiological examination. Transthoracic FNAB revealed chronic suppurative inflammation, with Cytology sputum Class II. Chest CT Angiography showed Lung TB Far advanced lesions accompanied by mediastinal lymphadenopathy with unsuspecting complications of left supreme intercostal artery aneurysm dd pseudoaneurysm, suggestion embolization. Examination results confirmed the diagnosis of recurrent massive haemoptysis and intercostal artery aneurysm with the history of TB. Embolization procedure was then performed. Conclusion: Angiography CT Scan has better detail in evaluating condition, source, amount, and tract of artery in chest cavity. Bronchial artery embolization as an alternative therapy was found to give better effect of occlusion.