The primary cause of hemoptysis is the bronchial artery. However, it should be noted that pulmonary artery and other vessels can cause hemoptysis. If the source of the bleeding is not determined after embolization, other evaluations are needed. Systemic-pulmonary anastomosis and pulmonary artery pseudo-aneurysm are rare vascular abnormalities with varying etiologies. An accurate and rapid diagnosis is needed in hemoptysis, since the cause may be life-threatening. We report a case of a 77-years-old man with persistent hemoptysis due to the right inferior phrenic artery - pulmonary artery anastomosis and pseudoaneurysm. After the embolization of the inferior phrenic artery, the hemoptysis was successfully treated.
Aneurysm, False ; Arteries ; Bronchial Arteries ; Hemoptysis ; Hemorrhage ; Humans ; Pulmonary Artery

Aged ; Bronchial Arteries ; pathology ; Bronchial Diseases ; complications ; Female ; Fistula ; etiology ; pathology ; Humans ; Pulmonary Artery ; pathology

Embolization of the bronchial artery is a well-established treatment for patients with hemoptysis. To our know ledge, a case involving an aberrant bronchial artery from the common carotid artery has never been reported. The authors describe a case in which an aberrant bronchial artery from the left common carotid artery was a potential hazard during embolization of the bronchial artery.
Angiography ; Bronchial Arteries* ; Carotid Artery, Common* ; Hemoptysis ; Humans

Behcet's disease is an important cause of fatal vasculitis in young adult males and vascular involvement has been reported in more than 25% of patients. Pulmonary vascular involvement has been found in 1~7.7% of patients and is known to be related to poor prognosis. A incidence of fatal hemoptysis is high in patients whose Behcet`s disease is complicated by pulmonary artery aneurysm (PAA). The recurrence of hemoptysis in PAA of Behcet's disease may result from inadequate medical therapy and complications of surgical treatment. We report a case with Behcet's disease whose fatal hemoptysis has been successfully treated with bronchial artery embolization.
Aneurysm ; Bronchial Arteries* ; Hemoptysis* ; Humans ; Incidence ; Male ; Prognosis ; Pulmonary Artery ; Recurrence ; Vasculitis ; Young Adult

Massive and untreated hemoptysis is associated with a >50% mortality rate. Since bleeding has a bronchial arterial origin in most patients, bronchial artery embolization (BAE) has become an accepted treatment in massive hemoptysis. The possibility of bleeding from pulmonary artery should be considered in patients in whom the bleeding focus cannot be found by Bronchial angiogram. Indeed, the bleeding occurs from a pulmonary artery in approximately 10% of patients with massive hemoptysis. The most common causes of bleeding from the pulmonary artery are pulmonary artery rupture associated with a Swan-Ganz catheter, infectious diseases and vasculitis. We report a rare case of a fistula between the right upper lobar pulmonary artery and the right upper lobar bronchus in a 71-year-old woman who presented with massive hemoptysis.
Aged ; Bronchi ; Bronchial Arteries ; Catheters ; Communicable Diseases ; Female ; Fistula* ; Hemoptysis* ; Hemorrhage ; Humans ; Mortality ; Pulmonary Artery ; Rupture ; Tuberculosis, Pulmonary* ; Vasculitis

We report a case of mature cystic teratoma of the anterior mediastinum that ruptured into the pulmonary artery requiring an emergent surgical treatment. A 39-year-old woman presented an episode of massive hemoptysis and treated with bronchial artery embolization (BAE). On the 10th day after BAE, however, she developed sudden massive hemoptysis and had a deteriorated mental status. For a definitive treatment, she underwent the left pneumonectomy and the tumor resection in the anterior mediastinum. On histologic examination, the tumor disclosed cystic structures composed of mature squamous epithelium, pilosebaceous glands, mature fat tissue, cartilage and bone tissue. Also, there was intrapulmonary hemorrhage due to left pulmonary artery invasion of the tumor.
Adult ; Bone and Bones ; Bronchial Arteries ; Cartilage ; Epithelium ; Female ; Hemoptysis ; Hemorrhage ; Humans ; Lung ; Mediastinum ; Pneumonectomy ; Pulmonary Artery* ; Teratoma*

Gestational choriocarcinoma is easily disseminated hematogenously and its hypervascular nature places the patient at risk of significant hemorrhage both at the sites of metastatic lesions and in the uterus. In addition, its tends to give rise to pseudoaneurysm formation. Treatment of the condition by percutaneous embolization has been reported in several published articles, and hemoperitoneum secondary to rupture of splenic metastasis of gestational choriocarcinoma has also been reported, as has angiographic embolization. Hemoptysis resulting from pulmonary metastasis and treatment by means of embolization of the bronchial artery have not been reported, however. In this article, we describe a case of hemoptysis and hemoperitoneum due to pulmonary and splenic metastasis of gestational choriocarcinoma. Treatment of the condition involved embolization of the bronchial artery and superselective embolization of the splenic artery.
Aneurysm, False ; Bronchial Arteries* ; Choriocarcinoma ; Female ; Hemoperitoneum* ; Hemoptysis* ; Hemorrhage ; Humans ; Neoplasm Metastasis ; Pregnancy ; Rupture ; Splenic Artery* ; Uterus

Bronchial artery embolization (BAE) is the mainstay treatment for massive haemoptysis. Herein we briefly discuss the tips and tricks of super-selective embolization of bronchial artery using N-butyl-2 cyanoacrylate (NBCA). Based on our experience, this technique produces a better resolution and exhibit high non- recurrence rate in the treatment of massive haemoptysis.
Bronchial artery

PURPOSE: To compare the effectiveness of embolization of the bronchial artery embolization for the management of hemoptysis in pulmonary tuberculosis cases with the severity of lung parenchymal injury and pleural infiltration, as seen on plain chest radiographs, and with the findings of angiography of the bronchial artery. MATERIALS AND METHODS: Among 265 patients with hemoptysis due to pulmonary tuberculosis, the findings of plain chest radiography and angiography of the bronchial artery were comparatively analyzed in the 206 for whom the results of follow up were available. The chest radiographic findings were lassified as follows: Type I refers to simple pulmonary tuberculosis; Type II includes cases in which pulmonary tuberculosis is complicated by bronchiectasis, aspergillosis, or cavitation; Type III is either Types I or II accompanied by pleural infiltrates limited to the lung apex, and Type IV includes cases in which pleural infiltrates have extended beyond the apex in the whole of the lung. Bronchial angiographic findings were divided into four groups : Group I consists of cases which show abnormalities of only the bronchial artery; Group II includes those in which abnormalities are seen in the bronchial artery and either the internal mammary or an ntercostal artery; Group III comprises cases which belong to Group I or II and in which a branch of the subclavian artery is abnormal, and Group IV includes those in which abnormalities occur in at least two branches of the subclavian artery, or there is direct visualization of hypervascularity of this vessel. The initial post-embolic hemostatic effect and the results of follow up were studied over a six-month period. RESULTS: As compared with simple pulmonary tuberculosis (Type I), we found that as the severity of pleural infiltration and complications revealed by plain chest radiographs increased (Type II, III, IV), so did the severity of the manifestation of systemic collateral arteries other than the bronchial artery, as depicted by increase on bronchial angiography. Early post-embolic hemostasis occurred in 96% of Type-I cases (47/49), 82% of Type II (36/44), 70% of Type III (28/40), and 55% of Type IV (40/73). The average success rate was 74% (151/205). During the six month follow-up period, continued hemostasis was found in 80% of Type-I patients (36/45), 75% of Type II (30/40), 59% of Type III (20/34), and 48% of Type IV (20/42). The average long-term hemostasis rate was 66% (106/161). CONCLUSION: Bronchial angiography shows that in systemic collateral arteries circulation increases very substantially, and in cases in which plain chest radiographs depict extensive pleural infiltration or complications associated with pulmonary tuberculosis, it is therefore difficult to expect good hemostatic results after embolization. In such instances we thus recommend aggressive treatment such as surgical intervention.
Angiography* ; Arteries ; Aspergillosis ; Bronchial Arteries ; Bronchiectasis ; Follow-Up Studies ; Hemoptysis* ; Hemostasis ; Humans ; Lung ; Radiography ; Radiography, Thoracic* ; Subclavian Artery ; Thorax* ; Tuberculosis, Pulmonary*

A 71-year-old male with known bronchiectasis and atrial fibrillation was admitted to Seoul St. Mary's Hospital with recurrent transient ischemic attack. Radiofrequency ablation was performed to resolve the patient's atrial fibrillation, but failed. However, a fistula between the left circumflex artery and the bilateral bronchial arteries was found on computed tomography. Fistula ligation and a left-side maze operation were planned due to his recurrent symptom of dizziness, and these procedures were successfully performed. After the operation, the fistula was completely divided and no recurrence of atrial fibrillation took place. A coronary-bronchial artery fistula is a rare anomaly, and can be safely treated by surgical repair.
Aged ; Arteries* ; Atrial Fibrillation ; Bronchial Arteries ; Bronchiectasis ; Catheter Ablation ; Coronary Artery Disease ; Dizziness ; Electrons* ; Fistula* ; Humans ; Ischemic Attack, Transient ; Ligation ; Male ; Myocardial Ischemia* ; Positron-Emission Tomography* ; Recurrence ; Seoul