title: Myocardial Infarction as a Complication of Bronchial Artery Embolization.
abstract: Bronchial artery embolization is now a common treatment for massive pulmonary hemoptysis if flexible bronchoscopy at the bedside failed to control the bleeding. Complications of this technique range from benign chest pain to devastating neurological impairments. We report the case of a 41-year-old man who developed an ST elevation myocardial infarction during bronchial artery embolization, presumably because of coronary embolism by injected particles. In this patient who had no previously known coronary artery disease, we retrospectively found a communication between the left bronchial artery and the circumflex coronary artery. This fistula was not visible on the initial angiographic view and likely opened because of the hemodynamic changes resulting from the embolization. This case advocates for careful search for bronchial-to-coronary arterial fistulas and the need for repeated angiographic views during embolization procedures.
authors.affiliation: Department of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Local 4211, Québec, QC, G1V 0A6, Canada. hugo.labbe.1@ulaval.ca.|CISSS de Chaudière-Appalaches, L'Hôtel-Dieu de Lévis, 143 Rue Wolfe, Lévis, QC, G6V 3Z1, Canada. hugo.labbe.1@ulaval.ca.|Direction de l'enseignement, L'Hôtel-Dieu de Lévis, Local 2801, 143 Rue Wolfe, Lévis, QC, G6V 3Z1, Canada. hugo.labbe.1@ulaval.ca.
authors.forename: Hugo
authors.identifier: http://orcid.org/0000-0002-4751-6659
authors.initials: H
authors.lastname: Labbé
authors.affiliation: Department of Emergency Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Local 4617, Québec, QC, G1V 0A6, Canada.|CISSS de Chaudière-Appalaches, L'Hôtel-Dieu de Lévis, 143 Rue Wolfe, Lévis, QC, G6V 3Z1, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Bordeleau
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Local 4853, Québec, QC, G1V 0A6, Canada.|CISSS de Chaudière-Appalaches, L'Hôtel-Dieu de Lévis, 143 Rue Wolfe, Lévis, QC, G6V 3Z1, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Drouin
authors.affiliation: Department of Emergency Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Local 4617, Québec, QC, G1V 0A6, Canada.|CISSS de Chaudière-Appalaches, L'Hôtel-Dieu de Lévis, 143 Rue Wolfe, Lévis, QC, G6V 3Z1, Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Archambault
mesh_terms: D000792:Angiography; D001981:Bronchial Arteries / Q000000981:diagnostic imaging; D001999:Bronchoscopy; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000209:etiology*; D004452:Echocardiography; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods*; D006469:Hemoptysis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology*
keywords: Arterial fistula; Bronchial artery; Embolization; Hemoptysis; Myocardial infarction