The Fate of Bronchial Artery Aneurysm Over the Last 25 Years: A Comprehensive Review and Pooled Analysis
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ID: 315788
2026
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Abstract
Abstract Background Bronchial artery aneurysms (BAAs) and pseudoaneurysms (BAPs) are rare but potentially life-threatening vascular abnormalities, often discovered incidentally or during evaluation for hemoptysis. Aims This pooled analysis aims to systematically evaluate the clinical characteristics, diagnostic modalities, treatment strategies, and outcomes of reported BAA/BAP cases. We further sought to identify factors associated with rupture and prognosis. Methods A comprehensive search of PubMed, Embase, Web of Science, and the Cochrane Library was performed in accordance with a modified PRISMA framework. Eligible studies included case reports and case series, published from 2000 to the present, that described patients with BAA/BAP and provided sufficient clinical data. Results From an initial yield of 457 studies, 134 studies with 151 patients were included for systematic review. Among 151 patients, 80% were symptomatic with solitary, predominantly mediastinal aneurysms. Rupture occurred in 27%. Ruptured aneurysms were significantly smaller, with a median size of 10 mm (IQR 6.25–22.5 mm) than unruptured ones with 21 mm (IQR 14–34 mm) (Figure 1, Table 1). Endovascular repair was the main treatment (83.7%), with overall technical and clinical success rates of 94.6% and 95.2%, respectively. Technical success did not differ by treatment type or any clinical variable (all p > 0.05) (Table 2). Complication rates were low and similar between endovascular and open repair (3.5% vs. 5.2%, p = 1.000). Conclusion BAAs and BAPs carry a substantial risk of rupture. Endovascular embolization remains the first-line treatment due to its high success and low morbidity rate. Improved reporting, standardized definitions of clinical success, and further multicenter registries could help refining treatment algorithms and long-term follow-up strategies for this rare condition.Table 1Univariate analysis of risk of Rupture.pngFor image description, please refer to the figure legend and surrounding text. Table 2Univariate analysis of Technical Success.pngFor image description, please refer to the figure legend and surrounding text.
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| Authors | K E Koumarelas, P M Dimopoulos, K Kotopoulos, L Kukulski, D Papazoglou, V Dabravolskaite, D Kotelis, V Makaloski |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag055.079
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| URL | |
| Keywords | Keywords not found |
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