Bronchoscopy-guided bronchial artery embolization: a case report

BACKGROUND: Dieulafoy's disease is characterized by anomalous submucosal arterial branches, often presenting with severe symptoms such as hemoptysis and respiratory infections. Although primarily reported in the gastrointestinal tract, its occurrence in the bronchi is rare and challenging to cure. Traditional bronchial artery embolization often struggles with precise localization of the abnormal vessels. This case highlights the innovative use of bronchoscopy-guided bronchial artery embolization, enhancing procedural accuracy and clinical outcomes. CASE PRESENTATION: A 60-year-old Chinese woman with no significant respiratory history presented with persistent cough and sputum production for over 8 months, worsening with chest tightness for more than 1 month. Imaging studies, including chest computed tomography and bronchial artery computed tomography angiography revealed a vascular malformation consistent with Dieulafoy's disease in the right middle lobe bronchus. Using bronchoscopy for localization, the patient underwent an accurate bronchial artery embolization. Post-procedure imaging confirmed successful embolization of the abnormal artery, leading to significant alleviation of symptoms. CONCLUSION: This case demonstrates the clinical use of bronchoscopy-guided bronchial artery embolization in managing bronchial Dieulafoy's disease. The innovative use of bronchoscopy for localization enhances procedural accuracy, potentially improving patient outcomes and reducing complications. This approach may offer a safer and more effective alternative to traditional bronchial artery embolization, especially in cases when precise localization is difficult. Bronchoscopy-guided bronchial artery embolization is feasible and prudent.