The Fate of Bronchial Artery Aneurysm over the Last 25 Years: A Systematic Review and Pooled Analysis

Purpose: Bronchial artery aneurysms (BAA) and pseudoaneurysms (BAP) are uncommon vascular lesions that may present incidentally with hemoptysis or following rupture. This systematic review and pooled analysis examined their clinical presentation, diagnostic assessment, management, and reported outcomes. Materials and Methods: PubMed, Embase, and the Cochrane Library were searched for case reports and case series published between January 2000 and December 2025. Studies reporting patients with BAA or BAP and sufficient clinical information were included, following the modified PRISMA guidelines. Results: Of 1431 identified records, 152 studies comprising 170 patients were included. Overall, 80% of patients were symptomatic, and most aneurysms were solitary and mediastinal. Rupture was reported in 28.4% of published cases. Endovascular treatment was the most frequently reported approach (83.7%). Technical success was achieved in 94.6% of cases overall and in 93.9% of endovascular procedures. Exploratory univariable analyses identified no significant association between technical success and treatment modality (p > 0.05). Reported complication rates were similar following endovascular and open treatment (3.8%, vs. 4.5%, p = 1.000). Conclusions: Rupture was frequently described among published BAA and BAP cases and endovascular treatment was the most commonly reported management strategy, with high observed success and few complications. However, the case-based evidence and associated selection and reporting biases, limit comparative or causal conclusions. Standardized outcome definitions, improved reporting, and multicenter registries are needed to clarify natural history and inform management strategies.