Two cases of bilateral bronchial artery varices: One with and one without bilateral coronary-to-pulmonary artery fistulas. Review and characterization of the clinical features of bronchial artery varices reported in Japan

Abstract

Babo et al. 1 Babo H. Huzly A. Deininger H.K. et al. [Angiomas and angioma-like changes of the bronchial arteries (author's transl)]. Rofo. 1976; 124: 103-110 Crossref PubMed Google Scholar first reported bronchial artery varices (BAVs), so-called racemose arteriovenous angiomas, in 1976, which were defined as morphological abnormalities of the bronchial arteries, such as dilatation and tortuosity, with or without anastomoses to either pulmonary arteries or veins. In the United States and Europe, diverse terminology has been used to describe this anomaly, including angioma racemosum arteriovenosum, 2 Deininger H.K. von Babo H. Franzen G. [Angiographic diagnosis of haemoptysis with particular reference to angiomas of the bronchial arteries (author's transl)]. Rontgenblatter. 1979; 32: 659-664 PubMed Google Scholar angioma arteriovenosum racemosum, pulmonary or bronchial arteriovenous malformation, 3 Uchiyama D. Fujimoto K. Uchida M. et al. Bronchial arteriovenous malformation: MDCT angiography findings. AJR Am J Roentgenol. 2007; 188: W409-W411 Crossref PubMed Scopus (16) Google Scholar or systemic to pulmonary vascular malformation, which occasionally includes fistulas of pulmonary arteries or veins. This diversity has led to difficulty in characterizing the clinical signs and symptoms of BAVs. Conversely, in Japan, since 1976, a new clinical entity called BAVs (racemose arteriovenous angioma) has been widely recognized, and 47 cases have been reported to date (Table 1), which enables its characteristic clinical findings to be identified. Herein, two cases of BAVs, one of which had bilateral coronary artery fistulas (CAFs) and the other of which had only BAV, are presented. B–P, right bronchial artery to the right pulmonary artery; BA, bronchial artery embolization; BAE. Re: Two cases of bilateral bronchial artery varices: One with and one without bilateral coronary-to-pulmonary artery fistulas. Review and characterization of the clinical features of bronchial artery varices reported in JapanClinical RadiologyVol. 68Issue 7PreviewSir — I happened to open the December 2012 edition of Clinical Radiology at this case report and, on reading the introduction, which included the comment that “a new clinical entity called bronchial artery varices (racemose arteriovenous angioma) has been widely recognized”, thought that the Journal had decided to introduce a new section containing unusual articles from the historical literature.1 On looking at the figures, however, which include state of the art computed tomography (CT) images, it was clear that this was not the case, and I thought instead that the Editor had decided to follow the lead of the British Medical Journal by producing a Christmas edition containing tongue-in-cheek articles. Full-Text PDF Re: Two cases of bilateral bronchial artery varices: One with and one without bilateral coronary-to-pulmonary artery fistulas. Review and characterization of the clinical features of bronchial artery varices reported in Japan. A replyClinical RadiologyVol. 68Issue 7PreviewSir — We read with interest the letter by Dr Jackson, which was strongly critical of our report.1 We described that our two cases were compatible with racemose arteriovenous angioma according to the criteria of Babo et al., defined as the presence of dilated bronchial arteries with or without fistulas of pulmonary arteries or veins, known as bronchial artery varices (BAVs). The term BAVs was considered equivalent in meaning to bronchial artery hypertrophy. Indeed, among 47 patients reported in Japan, 28 patients had fistulas from the bronchial artery to the pulmonary artery or vein described as “Table1” in our manuscript, Clin Radiol. Full-Text PDF