Bronchial Artery Embolization for the Treatment of Hemoptysis in Patients with Cystic Fibrosis

Brinson, George M.; Noone, Peadar G.; Mauro, Matthew A.; Knowles, Michael R.; Yankaskas, James R.; Sandhu, Jeet; Jaques, Paul F.

doi:10.1164/ajrccm.157.6.9708067

Cited by 149 publications

(123 citation statements)

References 20 publications

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“…It also allows collection of histologic samples, but is not useful in detecting peripheral tumors [10]. Bronchial angiography can localize potential bleeding sites and treat the bleeding by embolisation [11]. The combined use of bronchoscopy and CT chest has the best yield in evaluating haemoptysis [12].…”

Section: Discussionmentioning

confidence: 99%

Clinical-Radiological, Pathological Profile and Treatment Outcome of Patients with Haemoptysis

Joseph¹,

Nair²,

Pt³

2017

J Pulm Respir Med

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Section: Discussionmentioning

confidence: 99%

Clinical-Radiological, Pathological Profile and Treatment Outcome of Patients with Haemoptysis

Joseph¹,

Nair²,

Pt³

2017

J Pulm Respir Med

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“…It normally provides less than 1% of cardiac output to the lung but has been shown to increase to as much as 30% of the original pulmonary blood flow after chronic unilateral pulmonary artery obstruction (13). This pathological feature of bronchial angiogenesis occurs during conditions of chronic inflammation such as cystic fibrosis (4), asthma (12), pulmonary fibrosis (27), lung cancer (16), and chronic thromboembolic disease (18). In animal models, pulmonary ischemia resulting from chronic pulmonary artery obstruction has been shown to cause proliferation of the systemic circulation to the lung in sheep (5), pigs (8), dogs (13), rats (28), and mice (14).…”

mentioning

confidence: 99%

Inhibition of CXCR₂attenuates bronchial angiogenesis in the ischemic rat lung

Sukkar¹,

Jenkins²,

Sánchez³

et al. 2008

Journal of Applied Physiology

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. Inhibition of CXCR 2 attenuates bronchial angiogenesis in the ischemic rat lung. J Appl Physiol 104: 1470-1475, 2008. First published March 6, 2008 doi:10.1152/japplphysiol.00974.2007.-Under conditions of chronic pulmonary ischemia, the bronchial circulation undergoes massive proliferation. However, little is known regarding the mechanisms that promote neovascularization. An expanding body of literature implicates the glutamic acid-leucine-arginine (ELRϩ) CXC chemokines and their G protein-coupled receptor, CXCR 2, as key proangiogenic components in the lung. We used a rat model of chronic pulmonary ischemia induced by left pulmonary artery ligation (LPAL) to study bronchial angiogenesis. Using a methacrylate mixture, we cast the systemic vasculature of the rat lung at weekly intervals after LPAL. Twenty-one days after LPAL, numerous large, tortuous bronchial arteries were observed surrounding the left main bronchus that penetrated the left lung parenchyma. In stark contrast, the right lung was essentially devoid of vessels. We quantified bronchial neovascularization using 15-m radiolabeled microspheres to measure systemic blood flow to the left lung (n ϭ 12 rats). Results showed that by 21 days after LPAL, bronchial blood flow to the ischemic left lung had increased Ͼ10-fold compared with controls 2 days after LPAL (P Ͻ 0.01). Focusing on the predominant rat CXC chemokine that signals through CXCR 2, we measured increased levels of cytokine-induced neutrophil chemoattractant-3 protein expression in left lung homogenates early (4 and 24 h; n ϭ 10 rats) after LPAL relative to paired right lung controls (P Ͻ 0.01). Treatment with a neutralizing antibody to CXCR 2 resulted in a significant decrease in neovascularization 21 days after LPAL (n ϭ 9 rats; P Ͻ 0.01). Our results confirm the time course of bronchial angiogenesis in the rat and suggest the importance of CXC chemokines in promoting systemic neovascularization in the lung. bronchial artery; cytokine-induced neutrophil chemoattractant-3; microspheres THE BRONCHIAL CIRCULATION is the systemic vascular supply to the lung and provides nutrient blood flow to conducting airways down to the level of the terminal bronchioles as well as nerves, lymph nodes, visceral pleura, and walls of large pulmonary vessels. It normally provides less than 1% of cardiac output to the lung but has been shown to increase to as much as 30% of the original pulmonary blood flow after chronic unilateral pulmonary artery obstruction (13). This pathological feature of bronchial angiogenesis occurs during conditions of chronic inflammation such as cystic fibrosis (4), asthma (12), pulmonary fibrosis (27), lung cancer (16), and chronic thromboembolic disease (18). In animal models, pulmonary ischemia resulting from chronic pulmonary artery obstruction has been shown to cause proliferation of the systemic circulation to the lung in sheep (5), pigs (8), dogs (13), rats (28), and mice (14). However, little is known regarding the mechanisms that promote growth of bronchial arteries in chroni...

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“…Rabkin 27 reported on 13 CF patients undergoing 28 embolization procedures. Nine required only one embolotherapy session, whereas four required multiple (two or three) sessions to control the hemorrhage during a single hospital admission.…”

Section: Resultsmentioning

confidence: 99%