Hemoptysis: Bronchial and Nonbronchial Systemic Arteries at 16–Detector Row CT

Yoon, Young Cheol; Lee, Kyung Soo; Jeong, Yeon Joo; Shin, Sung Wook; Chung, Myung Jin; Kwon, O Jung

doi:10.1148/radiol.2341032079

Cited by 121 publications

(84 citation statements)

References 21 publications

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“…Arterioles from this plexus perforate the muscular layer and create a parallel plexus in the bronchial submucosa. In normal conditions the diameter of bronchial arteries is less than 1.5 mm at the origin and less than 0.5 mm more distally (21). They are usually considered hypertrophic and a potential source of hemoptysis when larger than 2 mm at the origin (22).…”

Section: Anatomy Of the Lung Arterial Blood Supplymentioning

confidence: 99%

Diagnosis and management of hemoptysis

Larici

Franchi²,

Occhipinti³

et al. 2014

Diagn Interv Radiol

149

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Hemoptysis is the expectoration of blood that originates from the lower respiratory tract. It is usually a self-limiting event but in fewer than 5% of cases it may be massive, representing a life-threatening condition that warrants urgent investigations and treatment. This article aims to provide a comprehensive literature review on hemoptysis, analyzing its causes and pathophysiologic mechanisms, and providing details about anatomy and imaging of systemic bronchial and nonbronchial arteries responsible for hemoptysis. Strengths and limits of chest radiography, bronchoscopy, multidetector computed tomography (MDCT), MDCT angiography and digital subtraction angiography to assess the cause and lead the treatment of hemoptysis were reported, with particular emphasis on MDCT angiography. Treatment options for recurrent or massive hemoptysis were summarized, highlighting the predominant role of bronchial artery embolization. Finally, a guide was proposed for managing massive and nonmassive hemoptysis, according to the most recent medical literature.

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Section: Anatomy Of the Lung Arterial Blood Supplymentioning

confidence: 99%

Diagnosis and management of hemoptysis

Larici

Franchi²,

Occhipinti³

et al. 2014

Diagn Interv Radiol

149

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“…Bronchial artery embolization (BAE) has been widely used in the treatment of massive hemoptysis in clinics owing to its exact therapeutic effectiveness, with an immediate success rate for hemoptysis of 90-95%. However, 5-10% of patients show hemostatic failure or recurrent bleeding shortly after treatment, which is closely related to the corporate offending vessels accompanied by non-bronchial systemic arteries (NBSA) involved in hemoptysis (Keller et al, 1987;Tamura et al, 1993;Sellars and Belli, 2001;Yoon et al, 2002Yoon et al, , 2003Yoon et al, , 2005Yu-Tang Goh et al, 2002;Andersen, 2006;Corr, 2006;Kim et al, 2006). In recent years, increasing attention has been paid to NBSA in hemoptysis treatment; however, the posterior intercostal arteries have been relatively neglected.…”

Section: Introductionmentioning

confidence: 99%

Correlation and interventional embolization therapy of posterior intercostal arteries-induced hemoptysis

Yp¹,

Yg²,

Jiang³

et al. 2014

Genet. Mol. Res.

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ABSTRACT. The incidence of posterior intercostal arteries-induced hemoptysis, its correlation with primary diseases, and the value of interventional embolization therapy were investigated. Clinical data, multislice spiral computed tomography (MSCT), digital subtraction angiography (DSA), and other imaging data of 143 cases of hemoptysis were retrospectively analyzed. After the offending vessels were subjected to interventional embolization therapy, patients were followedup for observations of clinical efficacies and complications. Thirty-one patients (21.7%) showed 65 branches of posterior intercostal arteries as the non-bronchial systemic arteries involved in hemoptysis; pleural thickening was evident in 25 (80.6%) cases. Posterior intercostal arteriesinduced hemoptysis was observed in 16 of the 27 (59.3%) patients with pulmonary tuberculosis, and in 9 of the 10 (90.0%) patients with pulmonary tuberculosis and pulmonary damage. Posterior intercostal Interventional embolization therapy of hemoptysis arteries-induced hemoptysis was correlated to pleural thickening (P <0.05), which differed significantly among different underlying diseases (P <0.05). Twenty-eight cases of 58 branches of posterior intercostal arteries were found to be involved in hemoptysis by preoperative chest CT angiogram (CTA); the intraoperative matching rates were 90.3% (28/31) and 89.2% (58/65), respectively. Thirty-one patients received transcatheter arterial embolization (TAE), of which 29 (93.5%) showed immediate hemostasis; 1 case had surgical treatment for ineffectuality, and 2 cases showed recurrence without serious complications. The posterior intercostal arteries were commonly involved in hemoptysis, and were closely associated with pleural thickening and pulmonary tuberculosis, especially when accompanied by pulmonary damage. Complete TAE could improve the treatment effect of hemoptysis and preoperative chest CTA was helpful for interventional embolization therapy.

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“…Bronchial arteries primarily deliver blood to the trachea, extra-and intrapulmonary airways, bronchovascular bundles, nerves, supporting structures, regional lymph nodes, visceral pleura, esophagus, the vasa vasorum of the aorta, and pulmonary arteries and veins. Pulmonary and bronchial arteries have rich and complex anastomoses at the capillary level (1,2).…”

mentioning

confidence: 99%

“…Enlarged bronchial arteries can easily be visualized as nodular or tubular structures within the mediastinum, around the central airways, or within the extrapleural fat planes on contrast-enhanced CT images (2,4,5).…”

mentioning

confidence: 99%

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Multi-detector CT imaging of bronchial & non-bronchial systemic arteries

Yıldız

Arıyürek²,

Akpınar³

et al. 2009

Diagn Interv Radiol

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We evaluate the use of multidetector row computed tomography (MDCT) angiography for the depiction of bronchial and non-bronchial systemic arteries (NBSAs), which frequently become enlarged as a secondary finding in a wide array of chronic lung diseases and other diseases that affect the pulmonary vascular system. MDCT angiography has enabled radiologists to provide thin-slice axial images, multi-planar reconstructions, interactive maximum intensity projections, and volume-rendered images to evaluate the origin and course of the abnormal bronchial arteries and enlarged NBSAs that may be the cause of hemoptysis. Embolization of the bronchial arteries is the primary treatment option in patients with massive hemoptysis. Precise localization of the bleeding vessel(s) prior to catheter arteriography not only is the most important factor for prompt and successful embolization but also prevents the recurrence of hemoptysis from missed NBSAs during procedures.

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Hemoptysis: Bronchial and Nonbronchial Systemic Arteries at 16–Detector Row CT

Abstract: Sixteen-detector row CT provides depiction and traceability of the bronchial arteries in patients with hemoptysis, and in most patients it enables detection of the bronchial and nonbronchial arteries causing hemoptysis.

Cited by 121 publications

References 21 publications

Diagnosis and management of hemoptysis

Diagnosis and management of hemoptysis

Correlation and interventional embolization therapy of posterior intercostal arteries-induced hemoptysis

Multi-detector CT imaging of bronchial & non-bronchial systemic arteries

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