Selective Bronchial and Intercostal Arteriography by A.S.J. Botenga

By A.S.J. Botenga

1. may a greater knowing of the anatomy and development of the strategy give the opportunity to lessen the proportion of mess ups sufficiently to earn selective arteriography of bronchial and intercostal arteries a spot one of the accredited equipment of selective arteriographic research? 2. Can symptoms for such selective arteriographical investigations be formulated? The solutions to those questions have been thought of to supply a foundation for the evaluate of the medical contribution to be anticipated of this system. In designing this learn venture, we all started through creating a targeted examine of the radiological and anatomical literature. I I LITERATURE 11.1. half I -RADIOLOGY large bronchial arteries could be proven by means of traditional radiological equipment. CAMPBELL AND GARDNER (1950), CSAKANY (1964) and KIEFFER ET AL. (1965) defined attribute images obvious on common X-ray's and RICHTER (1965) these noticeable on tomograms of the thorax. TAUSSIG (1947) and SEGERS AND BROMBART (1953) validated standard impressions within the esophagus. a few of these authors, together with CAMPBELL AND GARDNER (1950) and GARUSI (1961), observed extensive bronchial arteries on venous angiocardiograms, yet direct learn of the bronchial arteries can merely be performed by way of arteriography, which nonetheless has a slightly short historical past. study has been performed in canine and in guy; in basic terms the latter may be discussed.

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The aortograms made in the prone position after 10 seconds of straining gave the most information and the 'normal' aortograms made in the supine position the least (Fig. 6). Aortography done with the patient in the lateral position - either with or without straining - also gave very little information. 3 Technique 34 aortogram (subtraction) selective a b Fig. 7. Comparison of aortography (a) and selective catheterization (b). Patient with recurrent tumor in the right upper lobe. Only the selective picture shows vessels in the region of the tumor.

Conclusions An intercosto-bronchial trunk is present in four out of five cases. Because of its well-defined location and relatively large caliber, the artery need not be missed. When, however, a second intercostobronchial trunk is present, it may not always be found. A deliberate effort should be made to find the arteries supplying the 2nd and 3rd intercostal spaces, since almost four out of five intercosto-bronchial trunks supply these spaces. The occurrence of trunci communes A truncus communis with important branches to both lungs has a larger caliber than independent bronchial arteries and will therefore seldom be missed.

Only three had a diameter of more than 1 mm, one of these supplying the entire right lung. Discussion The bronchial arteries mentioned so far can be catheretized selectively, but this does not hold generally for those arising from the aortic arch. For the boundary between the descending aorta and the aortic arch we chose the horizontal tangent plane with the concave segment of the aortic arch, because bronchial arteries arising at higher levels cannot be selectively catheterized via the groin. We are aware that this is not the anatomical boundary, but as the discussion of the anatomical literature showed, this boundary was not localized exactly in any of the investigations, and the widely varying percentages (see table 6) show that it differed from one investigation to another.

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