PubMed · 491087
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K Okuda, H Nakada. 1979-06-29. [Bronchial artery circulation].. https://pubmed.ncbi.nlm.nih.gov/491087/
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This report describes a bronchial artery originating from the left gastric artery in a patient with recurrent massive haemoptysis caused by chronic pulmonary tuberculosis. The artery was not evident on the initial angiographic work-up including thoracic aortography, but it was evident in the selective angiography upon follow-up study. Haemoptysis was successfully controlled with transarterial embolisation. The left gastric artery should be included as a location for the possible origin of the bronchial artery.
A 47 year old male was admitted to the pulmonary medicine department in Landspítali University Hospital following a three day episode of massive hemoptysis but prior to admission he had been suffering from a dry cough for several weeks. Neither bronchoscopy nor a CT scan revealed the cause of bleeding and he was treated for bronchitis. Subsequently the bleeding stopped and he was discharged on Friday for a follow-up bronchoscopy to be performed three days later but only for that study to reveal continued bleeding and he was therefore readmitted. Two days later a selective bronchial arteriography was performed, showing vascular hyperemia and a bleeding site which was treated accordingly with endovascular embolization. Hemoptysis has not recurred on follow-up.
We encountered a case of primary racemose hemangioma treatment with successful bronchial artery embolism for massive hemoptysis. A 56-year-old woman with massive hemoptysis was transported to our hospital. The source of the massive hemoptysis was observed to be from around a non-pulsatile polyp covered by normal mucosa occluding the truncus intermedius by fiberoptic bronchoscopy. We stopped the bleeding temporarily using differential lung ventilation, and then bronchial artery angiography was performed. The main right bronchial artery was enlarged, and enlarged and convoluted right peripheral bronchial vessels were also observed. We diagnosed the massive bleeding to be due to racemose hemangioma. A successful bronchial artery embolization (BAE) was performed with gelforms and metallic coils for the treatment of racemose hemangioma. There has been no recurrence of hemoptysis for one year after BAE. There have been many reports on massive hemoptysis as in this patient who were treated by lobectomy, nevertheless we would like to state BAE should be considered as a suitable treatments for primary racemose hemangioma with hemoptysis if there is no recognizable shunt artery.