CTICasesBronchial Artery Aneurysm in Longstanding Bronchiectasis
Imaging findings
An elderly woman in her late 80s with long-standing, never fully worked-up bronchiectasis underwent a CT pulmonary angiogram for chest pain that incidentally detected a roughly 12-13 millimeter aneurysm arising from markedly enlarged, tortuous bronchial arteries in the subcarinal space, crossing the right hilum.
Key takeaways
Chronic bronchiectasis, regardless of underlying cause, can lead to marked bronchial artery hypertrophy and tortuosity with resultant aneurysm formation, and management of an incidentally discovered, asymptomatic (non-hemoptysis-associated) bronchial artery aneurysm in an elderly patient with comorbidities can reasonably favor conservative observation over percutaneous embolization given the uncertain natural history and lack of established treatment data.
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