Successful treatment of a primary racemose hemangioma using ligation and transection of the bronchial artery decided on the basis of the intra-operative arterial pressure

An 80-year-old woman presented with hemoptysis. Fiberoptic bronchoscopy revealed a blue, non-pulsatile, polypoid lesion at the orifice of the left upper division bronchus. Bronchial arteriography demonstrated convolution, dilatation, and pooling of contrast material in the left upper lobe. Since the bronchial arterial pressure decreased to the predicted pulmonary artery pressure after transient interruption between the aorta and proximal bronchial artery, the racemose hemangioma was presumed to be supplied mainly from the bronchial artery. She underwent ligation and transaction of the left bronchial artery, and had no further hemoptysis. Measurement of the bronchial arterial pressure is important for determining how to treat racemose hemangioma.