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The Pulmonary and Bronchial Vessels, Pulmonary Vascular Abnormalities including Embolism, Pulmonary and Bronchial Angiography, and A/V Malformations.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Other arterio-venous shunts - vascular shunting may also occur between the bronchial arteries and the pulmonary circulation in chronic pulmonary inflammatory or ischaemic conditions, e.g. congenital heart disease, bronchiectasis, fungus infections, etc, and between bronchial and pulmonary veins in severe emphysema. Other anastomoses may occur with the intercostal vessels, inferior phrenic artery, etc. and may occur with tumours involving the chest wall.
Microparticulate Carriers as a Therapeutic Option in Regional Cancer Therapy: Clinical Considerations
Published in Neville Willmott, John Daly, Microspheres and Regional Cancer Therapy, 2020
J. H. Anderson, Colin S. McArdle, T. G. Cooke
The lung, like the liver, has a dual blood supply. Lung tumors appear to be supplied by the bronchial arteries rather than the pulmonary artery.44 Selective cannulation of bronchial arteries is a difficult technique; therefore application of therapeutic strategies based on embolization of lung tumors is currently limited. However, Llaurado et al.45 administered 106 ion-exchange resin microspheres (diameter 53 to 63 μm) labeled with 740 MBq of 32P via lobar branches of the pulmonary artery of dogs and demonstrated organization and contraction of the treated lobe with minimal radioactivity in other tissues. There may be a place for “radioisotopic pulmonary lobectomy” in future human trials.
Functional imaging and emerging techniques in CT
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Vicky Goh, Christian Kelly-Morland, Davide Prezzi
The choice of kinetic model will depend on the underlying organ physiology. Both single- and dual-compartmental models have been applied with either a single or dual arterial input to reflect the blood supply to, and subsequent distribution within, an organ. For example, the lung receives a blood supply from the pulmonary and bronchial arteries. Hence, a dual arterial input would be appropriate, where the arterial time–concentration curves from both the pulmonary and bronchial arteries feed ‘supply’ information regarding contrast agent delivery rate into the model. Likewise, a dual-input, single-compartment model may be appropriate to model the distribution of contrast agent within the liver over time because of its dual vascular input (portal vein and hepatic artery) and the typical distribution of contrast agent within the normal liver: discontinuity of the sinusoid endothelium allows rapid passage of low-molecular-weight contrast agent into the relatively small extravascular–extracellular compartment (Space of Disse, 10% of liver volume).
Coronary-to-bronchial artery communication
Published in Acta Cardiologica, 2021
A 73-year-old Caucasian woman underwent a cardiology evaluation demonstrating an uncomplete right bundle branch block. She was asymptomatic and her past medical history was remarkable only for moderate treated dyslipidemia. A thoracic computed tomography (CT) scan with volume-rendered 3D offline reconstruction with and without intracardiac cavities contrast soustraction was performed to exclude coronary artery disease (Figure 1, left lateral view with cranial angulation, upper view with posterior angulation, posterior view with right angulation, Panels A,B,C respectively) showing coronary-to-bronchial artery communication: the originating artery was the left atrial branch of the left circumflex artery on S13 (white arrows, Figure 1) with a diameter of 3 mm and present a tortuous ascending tract, between the left auricular appendage and the left superior pulmonary vein at the beginning, then after between the left auriculum and the posterior wall of the ascending aorta. The ectopic artery divides into several bronchial arteries at the pulmonary right hilum. There was no significant coronary arterial stenosis. The prevalence of coronary artery fistula observed with CT scan is estimated at 0.9%, coronary to bronchial artery fistula representing 8.9% of them. Usually, these anatomical abnormalities are associated with abnormalities of the pulmonary vasculature or lung parenchyma leading to chronic pulmonary disease and bronchiectasis with haemoptysis. Since our patient was asymptomatic, we did not perform any invasive embolisation treatment procedure.
Preventing disease progression in Eisenmenger syndrome
Published in Expert Review of Cardiovascular Therapy, 2021
Ana Barradas-Pires, Andrew Constantine, Konstantinos Dimopoulos
Bleeding can manifest in many forms, including hemoptysis, epistaxis, mucocutaneous (gingival) and gastrointestinal bleeding, menorrhagia and cerebral bleeding. Hemoptysis is not infrequent, including in the context of a pneumonia, when it is usually mild and self-limiting. Life-threatening hemoptysis can occur in cases of significant pulmonary hemorrhage and requires emergency treatment, including urgent transfusion of red cells, platelets and other clotting factors, reversal of anticoagulation, lung isolation using single lung ventilation and involvement of interventional radiologists to embolize bleeding vessels (including hypertrophied bronchial arteries). Thoracic surgical involvement should be sought in severe cases, but rigid bronchoscopy and lobectomy carry their own risks. Hemoptysis has become less common as a mechanism of death since Paul Wood described his patient series over half a century ago, but pulmonary hemorrhage as a result of bronchial arterial bleeding, bleeding from aorto-pulmonary collaterals or aneurysmal pulmonary artery rupture remain most-often fatal events. Strategies for preventing this and other forms of bleeding need to be considered (Table 4), and managed with the appropriate specialist input, investigated and managed appropriately in a specialist center with PH and CHD input.
Cast of the left bronchial tree
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Marwa Oudah, Hargeet Sandhu, Fattoumata Sissoho, Bruce Sabath
She was intubated and immediate resuscitative efforts were able to achieve the return of spontaneous circulation. After stabilization, she underwent angiography which did not identify any active extravasation but embolization was performed of the main right and accessory right bronchial arteries as these appeared hypertrophied and irregular. Two days later, she again developed spontaneous massive hemoptysis with hypoxia and cardiopulmonary arrest. Ventilation became impossible, with significant resistance even with manual bagging through the endotracheal tube. She underwent emergent bedside bronchoscopy with visualization of a large blood clot extending from the left main stem bronchus into the trachea. This was removed bronchoscopically with a cryoprobe, showing a cast of the proximal left bronchial tree (Figure 1). She was then able to be ventilated easily.