Added Benefit of Thoracic Aortography After Transarterial Embolization in Patients with Hemoptysis

Chun, Ho Jong; Byun, Jae Young; Yoo, Seung‐Schik; Choi, Byung Gil

doi:10.2214/ajr.180.6.1801577

Cited by 34 publications

(20 citation statements)

References 17 publications

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“…These results suggest that multi-detector row helical CT angiography can help in the planning of a focused and efficient nonbronchial systemic artery embolization, as was recently reported with single-detector row CT (19). Consequently, thoracic aortography, an invasive procedure still recommended by many authors to improve the detection of arteries contributing to hemoptysis (30,31,(35)(36)(37), should be replaced with CT angiography. Similar conclusions can be drawn for the depiction of the abnormal systemic artery responsible for bronchial bleeding in patients with congenital anomalies of the lung.…”

Section: Discussionmentioning

confidence: 58%

Bronchial and Nonbronchial Systemic Arteries at Multi–Detector Row CT Angiography: Comparison with Conventional Angiography

Rémy‐Jardin¹,

Bouaziz²,

Dumont³

et al. 2004

Radiology

213

123

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Section: Discussionmentioning

confidence: 58%

Bronchial and Nonbronchial Systemic Arteries at Multi–Detector Row CT Angiography: Comparison with Conventional Angiography

Rémy‐Jardin¹,

Bouaziz²,

Dumont³

et al. 2004

Radiology

213

123

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“…In the subgroup of 26 patients referred for embolization, the anatomic information provided by CT angiograms guided successful catheterization and rapid embolization of ectopic and/or othotopic bronchial arteries in 21 patients, namely 81% of cases. From a practical standpoint, the noninvasive approach provided by CTA is expected to modify the recommendations for the angiographic procedures according to which thoracic aortography should be performed before [23] or after [24] bronchial artery embolization to identify all the systemic arterial supply to the bleeding site. Owing to the possibility to detect not only ectopic bronchial arteries, but also abnormal nonbronchial systemic arteries [10,25], CTA should contribute to the improvement of the immediate success rate of embolization whatever the underlying disease [26][27][28][29][30][31][32].…”

Section: Discussionmentioning

confidence: 99%

Ectopic origin of bronchial arteries: assessment with multidetector helical CT angiography

et al. 2007

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The purpose of this study was to determine non-invasively the frequency of ectopic bronchial arteries (BA) (i.e., bronchial arteries originating at a level of the descending aorta other than T5-T6 or from any aortic collateral vessel) on multidetector-row CT angiograms (CTA) obtained in patients with hemoptysis. Over a 5-year period (2000-2005), 251 consecutive patients with hemoptysis underwent multidetector-row CT angiography of the thorax. From this population, 37 patients were excluded because of a suboptimal CTA examination (n = 19), the presence of extensive mediastinal disease (n = 15) or severe chest deformation (n = 3) precluding any precise analysis of the bronchial arteries at CTA. Our final study group included 214 patients who underwent a thin-collimated CT angiogram (contrast agent: 300 to 350 mg/ml) on a 4- (n = 56), 16- (n = 119) and 64- (n = 39) detector-row scanner. The site of origin and distribution of bronchial arteries were analyzed on transverse CT scans, maximum intensity projections and volume-rendered images. The site of the ostium of a bronchial artery was coded as orthotopic when the artery originated from the descending aorta between the levels of the fifth and sixth thoracic vertebrae; all other bronchial arteries were considered ectopic. From the studied population, 137 (64%) patients had only orthotopic bronchial arteries, whereas 77 patients (36%) had at least one bronchial artery of ectopic origin. A total of 147 ectopic arteries were depicted, originating as common bronchial trunks (n = 23; 19%) or isolated right or left bronchial arteries (n = 101; 81%). The most frequent sites of origin of the 124 ostiums were the concavity of the aortic arch (92/124; 74%), the subclavian artery (13/124; 10.5%) and the descending aorta (10/124; 8.5%). The isolated ectopic bronchial arteries supplied the ipsilateral lung in all but three cases. Bronchial artery embolization was indicated in 26 patients. On the basis of CTA information, (1) bronchial embolization was attempted in 24 patients; it was technically successful in 21 patients (orthotopic BAs: 6 patients; orthotopic and ectopic BAs: 3 patients; ectopic BAs: 12 patients) and failed in 3 patients due to an instable catheterization of the ectopic BAs; the absence of additional bronchial arterial supply and no abnormalities of nonbronchial systemic arteries at CTA avoided additional arteriograms in these 3 patients; (2) owing to the iatrogenic risk of the embolization procedure of ectopic BAs, the surgical ligation of the abnormal vessels was the favored therapeutic option in 2 patients. This study enabled the depiction of ectopic bronchial arteries in 36% of the studied population, important anatomical information prior to therapeutic decision making.

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“…A number of authors have reported the occurrence of fistulous communication in the setting of hemoptysis[1–3] and ischemic coronary steal. [4–6] One case of hemoptysis has also been attributed to a fistula between a left bronchial artery and an internal mammary coronary artery bypass graft.…”

Section: Discussionmentioning

confidence: 99%

Case report: Complex internal mammary to pulmonary artery fistula as a cause of hemoptysis in tuberculosis: Diagnosis and endovascular management using ethylene vinyl alcohol copolymer (Onyx)

Pierce

Ahuja

Chadha

2011

Indian J Radiol Imaging

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Added Benefit of Thoracic Aortography After Transarterial Embolization in Patients with Hemoptysis

Cited by 34 publications

References 17 publications

Bronchial and Nonbronchial Systemic Arteries at Multi–Detector Row CT Angiography: Comparison with Conventional Angiography

Bronchial and Nonbronchial Systemic Arteries at Multi–Detector Row CT Angiography: Comparison with Conventional Angiography

Ectopic origin of bronchial arteries: assessment with multidetector helical CT angiography

Case report: Complex internal mammary to pulmonary artery fistula as a cause of hemoptysis in tuberculosis: Diagnosis and endovascular management using ethylene vinyl alcohol copolymer (Onyx)

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