Evaluation of the bronchial arteries: normal findings, hypertrophy and embolization in patients with hemoptysis

Abstract

The enlargement of the bronchial arteries occurs in a multitude of congenital and acquired diseases and is responsible for the majority of cases of hemoptysis. In this review, we provide a simplified imaging approach to the evaluation of the bronchial arteries. We highlight the anatomy and function of the bronchial arteries, typical imaging findings, how to recognize bronchial artery dilatation, and its underlying causes. Contrast-enhanced computer tomography plays a major role in diagnosing bronchial artery enlargement and also improves treatment planning. Bronchial artery embolization has proven to be effective in controlling the potential hazardous hemoptysis.

Development of a model to predict recurrence after bronchial artery embolization for non-cancer related hemoptysis

“…If the pulmonary circulation was compromised, impairment of the pulmonary circulation and an increased demand for oxygen in local lung tissue happened. Systemic arteries supplying the lung, mainly bronchial arteries, often increase their flow to compensate for decreased lung perfusion [ 30 , 31 ]. However, under such scenarios, the communications between the systemic arteries and pulmonary micro-circulation are prone to bleeding [ 32 ].…”

CIRSE Standards of Practice on Bronchial Artery Embolisation

“…Multidetector CT (MDCT) scan is superior to chest radiograph to identify both the anatomic origin and underlying cause of haemorrhage and to define the course of bronchial and non-bronchial systemic arteries [ 16 , 18 – 21 ].…”

“…Non-spherical, PVA particles, 355–500 µm in diameter were most commonly used [ 6 , 14 , 21 , 26 , 27 ]. Due to their non-uniform shape, PVA particles can aggregate and form plugs that result in premature embolisation proximal to the intended level [ 28 ].…”

“…Another 20% are first-order branches of the thoracic aorta or arch, but outside of the T5–T6 confines [ 56 ]. The remaining 10% originate from brachiocephalic, subclavian, internal mammary, pericardiophrenic, or abdominal (aorta, inferior phrenic, celiac) branches [ 21 , 24 , 55 , 56 ]. In contrast to the intercostal arteries, the bronchial arteries do not run parallel to the dorsal rib segments, but rather cross them.…”

Effects of preserving the bronchial artery on cough after thoracoscopic lobectomy

“…BA is a part of systemic circulation and is the nutrient vessel of lung. It dominantly supplies blood to the trachea, nerve tissue, esophagus, lymph node, visceral pleura and other organs 10 ; there are great differences in the origin, number, branch type and shape of BA among individuals. 11 BA injury can increase intraoperative bleeding, thereby leading to postoperative pulmonary complications.…”