Bronchial artery aneurysm suggested to be caused by metalic tracheal stent migration.

Abstract

Occurrence of bronchial artery aneurysm is rare, and it has been detected in less than 1 % of all selective bronchial arteriography cases. Here, we present a case of a bronchial artery aneurysm caused by a tracheal stent migration. A 59-year-old man was operated on for esophageal cancer, where an esophageal-tracheal fistula occurred 1 week after operation. Surgical repair of the esophageal-tracheal fistula was performed using a muscle flap, but this not results in fistula closure. Consequently, a self-expanding covered metallic tracheal stent was implanted for rescue, and this resulted in fistula closure. After 1 year, there was frequent hemoptysis caused by migration of the stent. He was referred to our hospital where removal of the stent was planned. A sudden occurrence of massive bleeding from trachea occurred, and extracorporeal membrane oxygenation (ECMO) was used. Although removal of tracheal stent was performed successfully, the patient subsequently died from multi-organ failure. Post-mortem autopsy revealed that the massive bleeding is originated from the rupture of a bronchial artery aneurysm.