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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
Wood and Miller (1938) and Cudkowicz and Armstrong (1953) considered that bronchial tumours might receive their main blood supply from the bronchial arteries, whilst metastases might be mainly perfused by the pulmonary circulation, a view supported by Darke and Lewtas (1968). It was also suggested that haemoptysis with bronchial tumours might in some cases be related to the higher blood pressure in the systemic bronchial circulation, as compared with the lower pressure in the pulmonary circulation supplying the secondary deposits. Besides malignant bronchial tumours having an increased bronchial circulation, this may also be found with more benign masses e.g. adenomas, hamartomas, etc. A hamartoma with a very vascular bronchial circulation was illustrated by Darke et al. (1972). In some cases metastases may derive a bronchial artery supply as shown by Turner-Warwick (1963a), Boijsen and Zsigmond (1965) and Noonan et al. (1965).
Pulmonary Tuberculosis
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Charles S. Dela Cruz, Barbara Seaworth, Graham Bothamley
The tissue destruction associated with cavitating post-primary TB, e.g., bronchiolar erosion with necrosis of adjacent blood vessels,53 Rasmussen's aneurysm54,55 and post-tuberculous bronchiectasis56 may cause massive hemoptysis, as can an aspergilloma (see later). The vascular supply of the lung consists of the low-pressure pulmonary circulation and the high-pressure bronchial circulation, from which most significant hemoptyses arise.57
Methods in Experimental Pathology of Pulmonary Vasculature
Published in Joan Gil, Models of Lung Disease, 2020
Paul Davies, Daphne deMello, Lynne M. Reid
The advent of heart and lung transplantation highlights the significance of the bronchial circulation. Although at transplantation routine bronchial circulation is not reestablished directly, preservation or reestablishment of the bronchial circulation by wrapping omentum around the anastomotic site or anastomosis of transplant bronchial vessels to the recipient’s intercostals results in better healing and fewer complications at the bronchial anastomosis (Fell et al., 1985; Lima et al., 1982; Mills et al., 1970; Morgan et al., 1982; Pinsker et al., 1980, 1984).
Methyl isocyanate inhalation induces tissue factor-dependent activation of coagulation in rats
Published in Drug and Chemical Toxicology, 2019
Raymond C. Rancourt, Jacqueline S. Rioux, Livia A. Veress, Rhonda B. Garlick, Claire R. Croutch, Eric Peters, William Sosna, Carl W. White
Previously we have identified several adverse effects resulting from inhalation of agents similar to MIC, including the alkylating agents half-mustard (2-choroethyl ethyl sulfide) and sulfur mustard. Among these findings were in vitro and in vivo evidence of activation of tissue factor (TF), activation of the clotting cascade, and fibrin deposition in the airways (Rancourt et al.2012). In addition, we found activation of intravascular coagulation resulting in thrombotic events in the lung vasculature (McGraw et al.2017). Leakage of plasma contents, including blood-clotting factors, into airways from the bronchial circulation further contributed to extravascular coagulation there. Finally, the persistence of such fibrinous lesions in airways was assured by the inhibition of multiple fibrinolytic pathways following inhalation of these TICs (Rancourt et al.2014). Here we report an early procoagulant effect, including a rapid, yet transient, expression of TF in the circulating plasma from MIC-exposed rats.
Management of severe hemoptysis
Published in Expert Review of Respiratory Medicine, 2018
Antoine Parrot, Sebastian Tavolaro, Guillaume Voiriot, Antony Canellas, Jalal Assouad, Jacques Cadranel, Muriel Fartoukh
There are a few relative contraindications to BAE. Among them, we find major hemostatic disorders (which in theory will be corrected), severe kidney failure, allergies to iodine, a significantly atheromatous aorta or an aorta at risk of dissection (Marfan disease), an anterior spinal or esophageal branch, and a shunt owing to a proximal obstruction of a pulmonary artery branch. Indeed, in this latter setting, bronchial circulation usually supplies the distal pulmonary circulation.
Inhaled cytotoxic chemotherapy: clinical challenges, recent developments, and future prospects
Published in Expert Opinion on Drug Delivery, 2021
Nathalie Wauthoz, Rémi Rosière, Karim Amighi
Inhalation, or pulmonary drug delivery, is an advantageous route of administration to treat pulmonary disorders. It has become the main route of administration of treatment against asthma or chronic obstructive pulmonary disease (COPD) and is used also to treat some pulmonary infections often encountered in cystic fibrosis or to treat pulmonary hypertension [13,14]. This noninvasive route of administration presents many advantages over systemic deliveries such as the oral or intravenous (iv) routes. These have a favorable pharmacokinetic profile because they limit systemic adverse effects and the first-pass metabolism by concentrating the drug into the site of action. This route of administration allows a lower dose to have a rapid onset and to have the same effect as a higher dose delivered by systemic routes [13,14]. These numerous advantages have led to this route of administration being evaluated for lung cancer therapy. The drug can be deposited topically, close to or on the tumors, which creates a favorable drug concentration gradient to diffuse into the tumor. Moreover, it allows the tumor to be reached another way than by vascularization, which is the main route in systemic treatments [15]. Some zones of tumors are poorly or non-vascularized, which renders them hypoxic [16]. A hypoxic environment favors invasive and resistant cancer cells or clonogenic cells responsible for tumor cell repopulation [7,16,17]. Moreover, as these zones are more distant from blood vessels, the cells are exposed to a much lower drug concentration from systemic routes even though they need a higher drug concentration to be killed [17–19]. Moreover, drug deposited into the lung is mainly absorbed into the local bloodstream and can also be drained by the lymphatic system [20,21]. This has been proven for a nebulized cisplatin (CIS) solution (dose of 40 mg) delivered to two stage II NSCLC patients two hours before surgery, evaluated by quantification of platinum in their lymph nodes (subcarinal node: 2.09 µg/g) and blood samples (0.13 µg/g) at 90 min post aerosol administration [22]. Therefore, lung deposited drug can follow the same routes as potential invasive cancer cells from a solid lung tumor (i.e. micrometastases) [7,20]. Moreover, depending on their localization, lung tumors are vascularized from either bronchial vascularization from bronchial arteries in the conducting zone (i.e. generation 0 to 16) or from pulmonary circulation in the transitional and respiratory zone (i.e. generation 17 to 23) [23]. As the pulmonary circulation receives the bronchial circulation, the tumors in the respiratory zone can also be reached from local blood circulation by the drug deposited in the larger airways, which represents a second access that can intensify the therapeutic response [21]. Therefore, lung tumors or metastases can be exposed to the drug topically or after it is absorbed or drained into the blood circulation and lymphatic system. In these cases, there is a favorable drug gradient concentration between the target tissue (tumor, lung, lymph node) and the blood (Figure 1).