Selective Bronchial Arteriography

Reuter, Stewart R.; Olin, Tord; Abrams, Herbert L.

doi:10.1148/84.1.87

Cited by 24 publications

(2 citation statements)

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“…1,2 Although bronchial artery anatomy and its variations were first described as early as 1948 through nonselective aortography and selective catheter angiography in 1964, it was not until 1977 that Remy et al first demonstrated the technique and clinical effectiveness of TAE for hemoptysis. [3][4][5][6][7] Subsequent reports not only supported early and successful utilization of bronchial artery embolization (BAE) in treating hemoptysis, but also elucidated the importance of nonbronchial systemic arterial supply to the diseased lung and the need for embolization of such nonbronchial arteries for sustained results. [8][9][10][11] Currently, TAE is recognized as the first-line management for bleeding control in patients with moderate-to-massive hemoptysis, 11,12 while surgery is preferred for definitive treatment given the long-term efficacy of removing the underlying diseased pulmonary tissue.…”

Section: Introductionmentioning

confidence: 99%

Nine-Year Single-Center Experience With Transcatheter Arterial Embolization for Hemoptysis: Medium-Term Outcomes

Dave

Sharma

Kalva

et al. 2011

Vasc Endovascular Surg

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Section: Introductionmentioning

confidence: 99%

Nine-Year Single-Center Experience With Transcatheter Arterial Embolization for Hemoptysis: Medium-Term Outcomes

Dave

Sharma

Kalva

et al. 2011

Vasc Endovascular Surg

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“…The pulmonary artery predominantly carries blood into the alveoli for oxygenation, whereas the bronchial artery supplies nutrition to the supporting lung tissues. Since the introduction of selective in vivo catheterization of bronchial arteries by Viamonte 10,11 and Reuter, 12 and postmortem microangiography by Milne, 13 blood supply to primary lung cancers has been shown to derive from the bronchial arteries. 7,[14][15][16] Occasionally a pulmonary artery component of supply is also present.…”

Section: Blood Supply Of Lung Cancersmentioning

confidence: 99%

Bronchial Artery Chemoinfusion Therapy for Unresectable Lung Cancer

Sun¹,

Lang²

1998

Semin intervent Radiol

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This article briefly reviews the current status of bronchial artery chemoinfusion therapy, and short-and long-term results, especially for unresectable non-small cell lung cancers. The rationale of bronchial artery chemoinfusion therapy, selection of patients and chemotherapy agents, and pretreatment evaluation are described. The technical issues involved in the procedure, including bronchial artery anatomy, angiographic technique, infusion of anticancer agents, and complications are also outlined. The promising tumor response rate indicates that bronchial artery chemoinfusion is effective in cytoreduction in advanced lung cancer, and can play an important role in multimodality management of non-small cell lung cancer.Regional arterial chemoinfusion has become part of the armamentarium for managing lung cancer in the Asian countries, but has been relatively neglected in the West. In this article we will outline the background, technical aspects, and clinical outcomes of bronchial artery chemoinfusion therapy.Recommendations are based on a review of the literature and the personal experience of one of the authors (S.S) with more than 500 such procedures.Lung cancer, in particular non-small cell lung cancer, is the most common malignancy diagnosed in the United States and the leading cause of cancer-related deaths. An estimated 177,000 patients were diagnosed with lung cancer in 1996; most died of their disease. 1 Reliable screening for early disease and curative therapy for advanced disease is lacking. The 5-year survival rate of approximately 10% to 14% has changed only minimally over the past several decades. 1-3 Treatment goals are, hence, largely extension of survival and improvement of symptoms and quality of life. Therefore, efforts have been directed toward identification of new chemotherapeutic agents with favorable activity/ toxicity. 4 In this context, intraarterial chemoinfusion therapy offers significant advantages: (a) arterial infusion provides increased drug delivery to the area supplied by the infused artery and (b) arterial infusion results in delivery of an appreciably reduced dosage of drug to the systemic circulation. 5 Models of linear pharmacokinetics predict a significant increase of drug concentration in the regional tissues when the flow rate of the artery receiving the infusion is small and the total body clearance of the drug is high. 5,6 Normal bronchial arteries measure approximately 1 to 2 mm in diameter, and receive only 1% of the cardiac output. When supplying a tumor, a bronchial artery enlarges, although not as extensively as when supplying inflammatory lung disease. 7 Murakami showed the concentration of platinum in surgical specimens including the primary tumor, surrounding parenchyma and lymph to be 3 times higher after branchial artery chemoinfusion therapy with cisplatinum than after intrave-

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