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Prevalence of non-bronchial systemic culprit arteries in patients with hemoptysis with bronchiectasis and chronic pulmonary infection who underwent de novo bronchial artery embolization

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Abstract

Objectives

To identify the prevalence of non-bronchial systemic culprit arteries and their relationship to bleeding lobes in patients with hemoptysis with bronchiectasis and chronic pulmonary infection who underwent de novo bronchial artery embolization (BAE).

Methods

Data of 83 consecutive patients with bronchiectasis and chronic pulmonary infection (non-tuberculous mycobacteriosis, aspergillosis, and tuberculosis) who underwent de novo BAE between January 2019 and December 2020 were retrospectively reviewed. The prevalence of culprit arteries was investigated.

Results

Fifty-five patients (66%) had 172 non-bronchial systemic culprit arteries. The bleeding lobes were the right upper, right middle, right lower, left upper, and left lower lobes in 14 (17%), 20 (24%), 7 (8%), 31 (37%), and 11 (13%) patients, respectively. The internal thoracic (49%; n = 41), intercostal (28%; n = 23), and inferior phrenic (28%; n = 23) arteries were the top three non-bronchial systemic culprit arteries, which were involved in all five types of bleeding lobes. The costocervical trunk and thoracoacromial and lateral thoracic arteries were predominant in patients with upper lobe bleeding. Ligament arteries were predominant in patients with left lower lobe bleeding.

Conclusions

These findings will better ensure the identification of non-bronchial systemic culprit arteries in patients with hemoptysis with bronchiectasis and chronic pulmonary infection. All systemic arteries, especially those which are adjacent to the lung lesions, should be evaluated carefully using MDCT; the internal thoracic, intercostal, and inferior phrenic arteries should be proactively assessed using angiography.

Key Points

• Non-bronchial systemic culprit arteries were identified in 66% of patients with hemoptysis with bronchiectasis and chronic pulmonary infection who underwent de novo bronchial artery embolization.

• The internal thoracic (49%), intercostal (28%), and inferior phrenic (28%) arteries were the top three arteries, which were involved in all five types of bleeding lobes.

• The costocervical trunk and thoracoacromial and lateral thoracic arteries were prominent in patients with upper lobe bleeding, and the ligament artery was prominent in patients with left lower lobe bleeding.

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References

  1. Panda A, Bhalla AS, Goyal A (2017) Bronchial artery embolization in hemoptysis: a systematic review. Diagn Interv Radiol 23:307–317

    Article  PubMed  PubMed Central  Google Scholar 

  2. Marquis KM, Raptis CA, Rajput MZ et al (2021) CT for evaluation of hemoptysis. RadioGraphics 41:742–761

    Article  PubMed  Google Scholar 

  3. Yoon W, Kim JK, Kim YH, Chung TW, Kang HK (2002) Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review. RadioGraphics 22:1395–1409

    Article  PubMed  Google Scholar 

  4. Li PJ, Yu H, Wang Y et al (2019) Multidetector computed tomography angiography prior to bronchial artery embolization helps detect culprit ectopic bronchial arteries and non-bronchial systemic arteries originating from subclavian and internal mammary arteries and improve hemoptysis-free early survival rate in patients with hemoptysis. Eur Radiol 29:1950–1958

    Article  PubMed  Google Scholar 

  5. Yoon YC, Lee KS, Jeong YJ, Shin SW, Chung MJ, Kwon OJ (2005) Hemoptysis: bronchial and nonbronchial systemic arteries at 16-detector row CT. Radiology 234:292–298

    Article  PubMed  Google Scholar 

  6. Xu S, Guan LJ, Shi BQ, Tan YS, Zhang XJ (2020) Recurrent hemoptysis after bronchial artery embolization: prediction using a nomogram and artificial neural network model. AJR Am J Roentgenol 215:1490–1498

    Article  PubMed  Google Scholar 

  7. Yoon W, Kim YH, Kim JK, Kim YC, Park JG, Kang HK (2003) Massive hemoptysis: prediction of nonbronchial systemic arterial supply with chest CT. Radiology 227:232–238

    Article  PubMed  Google Scholar 

  8. Ishikawa H, Hara M, Ryuge M et al (2017) Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study. BMJ Open 7:e014805

    Article  PubMed  PubMed Central  Google Scholar 

  9. Bruzzi JF, Rémy-Jardin M, Delhaye D, Teisseire A, Khalil C, Rémy J (2006) Multi-detector row CT of hemoptysis. RadioGraphics 26:3–22

    Article  PubMed  Google Scholar 

  10. Remy J, Remy-Jardin M, Voisin C (1992) Endovascular management of bronchial bleeding. In: Butler J (ed) The bronchial circulation. Dekker, New York, pp 667–723

    Google Scholar 

  11. Woo S, Yoon CJ, Chung JW et al (2013) Bronchial artery embolization to control hemoptysis: comparison of N-butyl-2-cyanoacrylate and polyvinyl alcohol particles. Radiology 269:594–602

    Article  PubMed  Google Scholar 

  12. Yoo DH, Yoon CJ, Kang SG, Burke CT, Lee JH, Lee CT (2011) Bronchial and nonbronchial systemic artery embolization in patients with major hemoptysis: safety and efficacy of N-butyl cyanoacrylate. AJR Am J Roentgenol 196:W199–W204

    Article  PubMed  Google Scholar 

  13. Zhang J, Zheng L, Zhao T, Huang S, Hu W (2020) A retrospective analysis of risk factors in recurrent hemoptysis patients with non-bronchial systematic artery feeding. Ann Transl Med 8:1593

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Jardin M, Remy J (1988) Control of hemoptysis: systemic angiography and anastomoses of the internal mammary artery. Radiology 168:377–383

    Article  CAS  PubMed  Google Scholar 

  15. Hashimoto M, Heianna J, Okane K, Izumi J, Watarai J (1999) Internal mammary artery embolization for hemoptysis. Acta Radiol 40:187–190

    Article  CAS  PubMed  Google Scholar 

  16. Vujic I, Pyle R, Hungerford GD, Griffin CN (1982) Angiography and therapeutic blockade in the control of hemoptysis. The importance of nonbronchial systemic arteries. Radiology 143:19–23

    Article  CAS  PubMed  Google Scholar 

  17. Cooper C, Moss AA, Buy JN, Stark DD (1983) CT appearance of the normal inferior pulmonary ligament. AJR Am J Roentgenol 141:237–240

    Article  CAS  PubMed  Google Scholar 

  18. Takeda K, Kawashima M, Masuda K et al (2020) Long-term outcomes of bronchial artery embolization for patients with non-mycobacterial non-fungal infection bronchiectasis. Respiration 99:961–969

    Article  PubMed  Google Scholar 

  19. Okuda K, Masuda K, Kawashima M et al (2016) Bronchial artery embolization to control hemoptysis in patients with Mycobacterium avium complex. Respir Investig 54:50–58

    Article  PubMed  Google Scholar 

  20. Ishikawa H, Ohbe H, Omachi N, Morita K, Yasunaga H (2021) Spinal cord infarction after bronchial artery embolization for hemoptysis: a nationwide observational study in Japan. Radiology 298:673–679

    Article  PubMed  Google Scholar 

  21. Kettenbach J, Ittrich H, Gaubert JY, Gebauer B, Vos JA (2022) CIRSE standards of practice on bronchial artery embolisation. Cardiovasc Interv Radiol 45:721–732

    Article  Google Scholar 

  22. Ryuge M, Hara M, Hiroe T et al (2019) Mechanisms of recurrent haemoptysis after super-selective bronchial artery coil embolisation: a single-centre retrospective observational study. Eur Radiol 29:707–715

    Article  PubMed  Google Scholar 

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Acknowledgements

We express our gratitude to Dr. Shigeo Shirakawa (president of Seiwakai Hospital Group), Dr. Masahiro Fukuzawa (chairman of Eishinkai Kishiwada Rehabilitation Hospital), and Mr. Unshow Shirakawa (vice president of Seiwakai Hospital Group).

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Hemoptysis and Pulmonary-Circulation Center, Eishinkai Kishiwada Rehabilitation Hospital, 2-8-10 Kamimatsu-cho, Kishiwada, City Osaka, 596-0827, Japan

    Takashi Nishihara, Hideo Ishikawa, Naoki Omachi, Yu Yamaguchi, Kazushi Kitaguchi & Tomoaki Hattori

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  1. Takashi Nishihara
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  2. Hideo Ishikawa
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  3. Naoki Omachi
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  4. Yu Yamaguchi
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  5. Kazushi Kitaguchi
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  6. Tomoaki Hattori
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Correspondence to Takashi Nishihara.

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The scientific guarantor of this publication is Takashi Nishihara.

Conflict of interest

Activities not related to the present article: the institution received research grants from Terumo.

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

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Written informed consent was obtained from all subjects (patients) in this study.

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Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Nishihara, T., Ishikawa, H., Omachi, N. et al. Prevalence of non-bronchial systemic culprit arteries in patients with hemoptysis with bronchiectasis and chronic pulmonary infection who underwent de novo bronchial artery embolization. Eur Radiol 33, 4198–4204 (2023). https://doi.org/10.1007/s00330-022-09310-4

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  • DOI: https://doi.org/10.1007/s00330-022-09310-4

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