Anomalous Systemic Arterial Supply to the Basal Segment of the Lung (ABLL) in the Right Lower Lobe: Preoperative Embolization and Thoracoscopic Surgery

Anomalous systemic arterial supply to the basal segment of the lung (ABLL) is a rare congenital anomaly. Surgical resection is the standard treatment to prevent complications like hemoptysis. Right-sided ABLL, often characterized by longer and more complex vascular anatomy, poses a higher risk of bleeding. Preoperative planning and embolization techniques are crucial for successful surgical outcomes. This case of right-sided ABLL is presented to emphasize the importance of these strategies. A 55-year-old woman experienced right lower abdominal pain. Incidental findings on computed tomography revealed an abnormal vessel supplying segment 10 of the right lower lobe, diagnosed as ABLL. To minimize intraoperative hemorrhage, preoperative embolization with a vascular plug was performed. Video-assisted thoracoscopic surgery was subsequently undertaken. The aberrant artery was divided with an endoscopic stapler, and a wedge resection of the affected lung was performed. This case report demonstrates the benefits of combining embolization and surgical resection for right-sided ABLL. This approach would reduce the risk of intraoperative bleeding.