A rare case of spinal cord and posterior circulation infarction after bronchial artery embolization

Background: Bronchial artery embolization (BAE) is a first-line therapy for massive hemoptysis. However, spinal cord and posterior circulation infarction are rare but severe complications. Case Presentation: A 56-year-old male with bronchiectasis presented with recurrent hemoptysis (>500 mL/24h). BAEwas performed using microspheres (500-900μm). Postoperatively, he developed paraplegia, urinary retention, and posterior circulation infarctions (right occipital lobe and left cerebellum).Despite rehabilitation, lower limb motor and sensory deficits persisted at 2-year follow-up. Conclusion: This case highlights the risk of dual spinal and cerebral infarction post-BAE. Interventional radiologists must meticulously avoid embolizing spinal collaterals and monitor injection pressure to prevent reflux. Preoperative spinal artery mapping (e.g., Wada test) may reduce complications.