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Endovascular Embolization of Bronchial Artery Originating from the Upper Portion of Aortic Arch in Patients with Massive Hemoptysis

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Abstract

Purpose

Our experience with endovascular embolization (EVE) of the bronchial artery (BA) originating from the upper portion of the aortic arch (AA) in six patients is described.

Methods

Altogether, 818 patients with hemoptysis underwent multidetector row computed tomography angiography (MDCTA) before EVE or AA angiography during EVE. Aberrant BAs originating from the upper portion of the AA were the source of massive hemoptysis in six patients (0.73 %). MDCT angiograms and/or Digital subtraction angiograms were retrospectively reviewed. Selective catheterization and embolization were performed.

Results

The ostia of the BAs were located on the superior surface of the AA between the brachiocephalic trunk and left common carotid artery in three patients, the junction of the aorta and medial surface of the left subclavian artery in two, and the posterior wall of the upper portion of the AA in one. The six BAs comprised two common trunks, three single right sides, and one single left side. The targeted vessels were successfully catheterized and embolized by a coaxial microcatheter system using polyvinyl alcohol particles. Other pathologic BAs and nonbronchial systemic arteries also were embolized. Bleeding was immediately controlled in all patients with no recurrence of hemoptysis. No procedure-related complications occurred.

Conclusions

Application of EVE of anomalous origin of BAs in patients with hemoptysis is important, as demonstrated in the six reported patients. MDCTA before EVE or AA angiography during EVE is critical to avoid missing a rare aberrant BA originating from the upper portion of the AA.

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Abbreviations

BA:

Bronchial artery

EVE:

Endovascular embolization

AA:

Aortic arch

MDCTA:

Multidetector row computed tomography angiography

References

  1. Remy J, Arnaud A, Fardou H, Giraud R, Voisin C (1977) Treatment of hemoptysis by embolization of bronchial arteries. Radiology 122:33–37

    CAS  PubMed  Google Scholar 

  2. Sancho C, Escalante E, Dominguez J, Vidal J, Lopez E, Valldeperas J, Montañá XJ (1998) Embolization of bronchial arteries of anomalous origin. Cardiovasc Intervent Radiol 21:300–304

    Article  CAS  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. Hartmann IJ, Remy-Jardin M, Menchini L, Teisseire A, Khalil C, Remy J (2007) Ectopic origin of bronchial arteries: assessment with multidetector helical CT angiography. Eur Radiol 17:1943–1953

    Article  PubMed  Google Scholar 

  5. Yu-Tang Goh P, Lin M, Teo N, En Shen Wong D (2002) Embolization for hemoptysis: a six -year review. Cardiovasc Intervent Radiol 25:17–25

    Article  PubMed  Google Scholar 

  6. McPherson S, Routh WD, Nath H, Keller FS (1990) Anomalous origin of bronchial arteries: potential pitfall of embolotherapy for hemoptysis. J Vasc Interv Radiol 1:86–88

    Article  CAS  PubMed  Google Scholar 

  7. Uflacker R, Kaemmerer A, Picon PD et al (1985) Bronchial artery embolization in the management of hemoptysis: technical aspects and long-term results. Radiology 157:637–644

    CAS  PubMed  Google Scholar 

  8. Remy-Jardin M, Bouaziz N, Dumont P, Brillet PY, Bruzzi J, Remy J (2004) Bronchial and nonbronchial systemic arteries at multi-detector row CT angiography: comparison with conventional angiography. Radiology 233:741–749

    Article  PubMed  Google Scholar 

  9. Chun HJ, Byun JY, Yoo SS, Choi BG (2003) Added benefit of thoracic aortography after transarterial embolization in patients with hemoptysis. AJR Am J Roentgenol 180:1577–1581

    Article  PubMed  Google Scholar 

  10. Phillips S, Ruttley MS (2000) Bronchial artery embolization: the importance of preliminary thoracic aortography. Clin Radiol 55:317–319

    Article  CAS  PubMed  Google Scholar 

  11. Khalil A, Parrot A, Nedelcu C, Fartoukh M, Marsault C, Carette MF (2008) Severe hemoptysis of pulmonary arterial origin: signs and role of multidetector row CT angiography. Chest 133:212–219

    Article  PubMed  Google Scholar 

  12. Cauldwell EM, Siekert RG, Lininger RE (1948) The bronchial arteries: an anatomic study of 150 human cadavers. Surg Gynecol Obstet 86:395–412

    CAS  PubMed  Google Scholar 

  13. O’Rahilly R, Debson H, Summerfield TK (1950) Subclavian origin of bronchial arteries. Anat Rec 108:227–239

    Article  PubMed  Google Scholar 

  14. Gailloud P, Albayram S, Heck DV et al (2002) Superior bronchial artery arising from the left common carotid artery: embryology and clinical considerations. J Vasc Interv Radiol 13:851–853

    Article  PubMed  Google Scholar 

  15. Boyden EA (1970) The developing bronchial arteries in a fetus of the twelfth week. Am J Anat 129:357–368

    Article  CAS  PubMed  Google Scholar 

  16. Amrhein TJ, Kim C, Smith TP et al (2011) Bronchial artery arising from the left vertebral artery: case report and review of the literature. J Clin Imaging Sci 1:62

    Article  PubMed Central  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, Shanghai, 200433, China

    Sen Jiang, Xi-Wen Sun, Dong Yu & Bing Jie

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  1. Sen Jiang
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  2. Xi-Wen Sun
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  3. Dong Yu
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  4. Bing Jie
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Correspondence to Sen Jiang.

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Jiang, S., Sun, XW., Yu, D. et al. Endovascular Embolization of Bronchial Artery Originating from the Upper Portion of Aortic Arch in Patients with Massive Hemoptysis. Cardiovasc Intervent Radiol 37, 94–100 (2014). https://doi.org/10.1007/s00270-013-0638-7

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  • DOI: https://doi.org/10.1007/s00270-013-0638-7

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