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Added Benefit of Thoracic Aortography After Transarterial Embolization in Patients with Hemoptysis

Ho Jong Chun1, Jae Young Byun1, Seung-Schik Yoo2 and Byung Gil Choi1

1 Department of Radiology, Kangnam St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul 137-040, Korea.
2 Present address: Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115.



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  		Fig. 1A. —53-year-old man with pulmonary tuberculosis. Bronchial arteriogram shows left bronchial artery to be hypertrophied with abnormal parenchymal stain (arrows) in left upper lobe.

 


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  		Fig. 1B. —53-year-old man with pulmonary tuberculosis. After embolization of left bronchial artery using Gelfoam ([gelatin sponge particles], Pharmacia and Upjohn, Kalamazoo, MI) and microcoils, thoracic aortogram shows no remaining opacification of left bronchial artery or abnormal parenchymal stain in left upper lobe.

 


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  		Fig. 1C. —53-year-old man with pulmonary tuberculosis. Late phase thoracic aortogram shows 5-French pigtail catheter (arrow) (Pig, Cook, Bloomington, IN) located distal to origin of left subclavian artery. Note microcoils (arrowhead) (Tornado, Cook) from initial embolization.

 


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  		Fig. 2A. —35-year-old man with pulmonary tuberculosis. Bronchial arteriogram shows left bronchial artery to be hypertrophied along with abnormal parenchymal stain and systemic pulmonary shunt (arrow) in left upper lobe. Left bronchial artery was selected and embolized with polyvinyl alcohol particles (Contour, Boston Scientific, Cork, Ireland).

 


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  		Fig. 2B. —35-year-old man with pulmonary tuberculosis. Postembolization aortogram shows abnormal hypervascular stain (arrows) in left perihilar lung.

 


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  		Fig. 2C. —35-year-old man with pulmonary tuberculosis. After additional left bronchial artery was selected with 5-French bronchial catheter (Bronchial, Jungsung, Seoul, Korea), selective arteriogram shows tortuous hypertrophy with parenchymal stain.

 


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  		Fig. 3A. —57-year-old woman with pulmonary tuberculosis and cystic bronchiectasis. After embolization of both bronchial arteries, thoracic aortogram shows hypertrophy with suspicious parenchymal stains (arrows) involving left highest and fifth intercostal arteries and inferior phrenic arteries.

 


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  		Fig. 3B. —57-year-old woman with pulmonary tuberculosis and cystic bronchiectasis. Selective arteriograms show tortuous hypertrophy of left highest (arrow, B) and fifth intercostal arteries (arrow, C) and inferior phrenic arteries (arrow, D) associated with parenchymal stains and arteriovenous shunts.

 


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  		Fig. 3C. —57-year-old woman with pulmonary tuberculosis and cystic bronchiectasis. Selective arteriograms show tortuous hypertrophy of left highest (arrow, B) and fifth intercostal arteries (arrow, C) and inferior phrenic arteries (arrow, D) associated with parenchymal stains and arteriovenous shunts.

 


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  		Fig. 3D. —57-year-old woman with pulmonary tuberculosis and cystic bronchiectasis. Selective arteriograms show tortuous hypertrophy of left highest (arrow, B) and fifth intercostal arteries (arrow, C) and inferior phrenic arteries (arrow, D) associated with parenchymal stains and arteriovenous shunts.

 

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