Two patients with coronavirus disease 2019 (COVID-19) infection (65 and 67 years old, receiving oxygen therapy via high-flow nasal cannulae, with no history of chronic respiratory disease or hemoptysis) were treated for psoas hematomata secondary to therapeutic anticoagulation (1 patient for a subsegmental pulmonary embolism and the other for an elevation of D-dimer level). In both the patients, computed tomography of the chest showed typical features of parenchymal lung abnormalities, consistent with COVID-19, and no chronic thromboembolic disease, bronchiectasis, or other conditions associated with bronchial artery dilatation.
Both the patients consented to investigational bronchial arteriography after embolization of the psoas bleeding sources. Angiography showed prominent bronchial arteries and parenchymal enhancement similar to those observed in tumor blushes (Fig 1 , Video 1). COVID-19 infection is associated with microangiopathy, thrombosis, and angiogenesis. Further studies are needed to determine whether hypervascularization is a beneficial adaptation or a pathologic process, in which case endovascular therapies should be evaluated to regulate it.
Figure 1.
Angiography of patient 1 demonstrated bronchial artery hypertrophy and contrast enhancement similar to that observed in tumor blushes.
Footnotes
None of the authors have identified a conflict of interest.
Video 1 can be found by accessing the online version of this article on www.jvir.org and selecting the Supplemental Material tab.
Supplementary Material
Angiography of the intercostal-bronchial trunk in patient 2 showed similar hypervascularity.
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Supplementary Materials
Angiography of the intercostal-bronchial trunk in patient 2 showed similar hypervascularity.