Selective bronchial arteriography and CTA can reveal dilated bronchial arteries
, abnormal arteries, vascular shunts, fistulae, and extravasation of contrast into the lungs, which can be helpful in making the diagnosis and ruling out other causes of hemoptysis. If lesions of the bronchial arteries
fail to show up, pulmonary arteriography would be essential.
Subsequently, according to the location of the target lesion, the bronchial arteries
were selectively catheterized using 4 F Cobra (Cook Medical) or Simmons catheter (Cordis, Johnson & Johnson Medical), and following angiography was performed to localize the bleeding site.
According to the transthoracic echography, the case reported here differs from those previously described lacking any signs of pulmonary hypertension, and it seems possible that their pulmonary perfusion was maintained via the bronchial arteries
Either 4F or 5F curved Cobra or Judkin's Right catheters were utilised for catheterisation of the bronchial arteries
. Search for the bronchial artery opening was made at D4 to D6 Levels and if necessary it was extended to the intercostal, diaphragmatic and internal and lateral thoracic arteries.
Collateral arteries have also been described as persistent, abnormally dilated arteries that connect the bronchial arteries
to the pulmonary circulation secondary to external factors such as hypoxia, trauma or inflammation.
Its main etiology is secondary to rupture of the bronchial arteries
and rarely from other systemic arteries or the pulmonary artery .
The middle esophageal blood supply is derived from the bronchial arteries
, right third or fourth intercostal arteries, and numerous small esophageal arteries off the descending aorta.
Dominguez et al., "Embolization of bronchial arteries
of anomalous origin," CardioVascular and Interventional Radiology, vol.
The pulmonary artery is absent in type IV (absence of the 6th aortic arches) and blood supply to the lungs is via the bronchial arteries
and is now considered to be pulmonary atresia with a VSD [4, 23].
The bronchial arteries
are the source of bleeding in most cases.
(1) The haemoptysis usually originates from the bronchial arteries
but rupture of an underlying Rasmussen aneurysm might cause recurrent haemoptysis, sometimes with fatal consequences.
Anomalous origin of the coronary artery is a well-known phenomenon however anomalous bronchial arteries
are rarely seen and may originate from various vascular structures.