The anatomy of the bronchial artery in sheep has recently been described. However, the course of the bronchial veins has not been well established. It has been suggested that the bronchial veins are the major site of fluid leakage following histamine infusion, and it has been postulated that the bronchial circulation may play a role in fluid reabsorption. We studied the anatomy of the bronchial circulation in 18 sheep with emphasis on bronchial venous drainage and bronchopulmonary communications. Following anesthesia animals were heparinized and exsanguinated. Evans blue dye was infused into the bronchial artery in six sheep and the gross and subgross anatomy of the bronchial circulation studied. In six other sheep the bronchial artery, pulmonary artery, and tracheobronchial tree were filled with Batson's solution of varying colors. The subgross anatomy was studied under a dissecting microscope, and samples were taken for scanning electron microscopy. In six separate sheep we studied the anatomy of the proximal vein by infusing dye directly into the vein and found that the extrapulmonary bronchial blood drained into the left azygos vein via a single vessel. Intrapulmonary bronchi are surrounded by a dense bronchial microvascular plexus which drains into the pulmonary vessels at the precapillary level.

We studied the bronchial arterial blood flow (Qbr) and bronchial vascular resistance (BVR) in sheep prepared with carotid-bronchial artery shunt. Nine adult sheep were anesthetized, and through a left thoracotomy a heparinized Teflon-tipped Silastic catheter was introduced into the bronchial artery. The other end of the catheter was brought out through the chest wall and through a neck incision was introduced into the carotid artery. A reservoir filled with warm heparinized blood was connected to this shunt. The height of blood column in the reservoir was kept constant at 150 cm by adding more blood. Qbr was measured, after interrupting the carotid-bronchial artery flow, by the changes in the reservoir volume. The bronchial arterial back pressure (Pbr) was measured through the shunt when both carotid-bronchial artery and reservoir Qbr had been temporarily interrupted. The mean Qbr was 34.1 +/- 2.9 (SE) ml/min, Pbr = 17.5 +/- 3.3 cmH2O, BVR = 3.9 +/- 0.5 cmH2O X ml-1 X min, mean pulmonary arterial pressure = 21.5 +/- 3.6 cmH2O, and pulmonary capillary wedge pressure (Ppcw) = 14.3 +/- 3.7 cmH2O. We further studied the effect of increased left atrial pressure on these parameters by inflating a balloon in the left atrium. The left atrial balloon inflation increased Ppcw to 25.3 +/- 3.1 cmH2O, Qbr decreased to 21.8 +/- 2.4 ml/min (P less than 0.05), and BVR increased to 5.5 +/- 1.0 cmH2O.ml-1.min (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

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Radioembolization is a safe local-regional treatment option in chemorefractory, inoperable CRCLM. Radioembolization at earlier stages may lead to more favorable results especially with lower tumor burden patients.

We studied the systemic arterial blood supply to the trachea and lung in adult sheep. After anesthesia, sheep were exsanguinated and then studied by intra-arterial injection of one of the following materials: saline containing dyes of various colors (n = 24), Microfil (n = 8), or Batson's solution (n = 6). The systemic blood supply to the cervical trachea originated from the two common carotid arteries via three to four small branches (rami tracheales cervicales) on each side. A segment of the thoracic trachea between the thoracic inlet and the origin of the tracheal bronchus (bronchus trachealis) and the bronchial tree of the right cranial lobe (lobus cranialis dexter) were supplied by the tracheal bronchial branch (ramus bronchalis trachealis), which originated from the brachiocephalic trunk (truncus brachiocephalicus). A portion of thoracic trachea between the origin of the tracheal bronchus and the tracheal carina was supplied by the thoracic tracheal branch (ramus trachealis thoracica), arising from the bronchoesophageal artery (arteria bronchoesophagea) or directly from the thoracic aorta. The bronchial branch (ramus bronchalis) originated from the bronchoesophageal artery, and its branches supplied the remainder of the bronchial tree. At 120 cmH2O pressure (n = 8), the bronchial branch contributed approximately 50% and the other two approximately 25% each of the total tracheobronchial blood flow. These three branches also supplied the visceral pleura. Additionally, several small vessels (rami pleurales pulmonales) originated from the esophageal branch (ramus esophagea) of the bronchoesophageal artery, traversed the pulmonary ligaments, and supplied the visceral pleura.