Localized bronchiectasis is a definite association of coronaro-bronchial artery fistula.

An 81-year-old smoker presented with acute coronary syndrome. Coronary angiography revealed severe double-vessel disease, as well as the incidental finding of a coronaro-bronchial artery fistula that arose from the left circumflex artery. Percutaneous coronary intervention was performed on the culprit lesion in the left anterior descending artery. A subsequent high-resolution computed tomography of the thorax revealed mild bronchiectic change in the corresponding area supplied by the coronaro-bronchial artery fistula. The patient had a normal lung function test and never had any chest symptoms. From the literature, the association of the coronaro-bronchial artery fistula and localized bronchiectasis is very definite, but the pathophysiology is still controversial.