Anomalous Vascular Supply of Bronchial Circulation in Cystic Fibrosis Patients with Massive Hemoptysis

Author(s): Rebanta Chakraborty, Alexander E. Trebelev, Brian Bianco, William O’Connell, Michael J. Stephen, Jeffrey B. Hoag.

Journal Name: Current Respiratory Medicine Reviews

Volume 9 , Issue 6 , 2013

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Abstract:

Background: Hemoptysis occurs commonly in patients with Cystic Fibrosis, and massive bleeding requiring emergent intervention occurs in a subset. Bronchial artery embolization (BAE) is recommended in clinically unstable CF patients with massive hemoptysis (MH); however, no consensus exists regarding selective versus extensive embolization, and recommendations of targets are scant.

Objective: We sought to characterize the frequency of abnormal bronchial circulation in MH in CF in order to suggest interventional approach for BAE.

Methods: A retrospective chart review of BAE for MH was performed. Characterization of angiography was described, and CF and non-CF patients were compared.

Results: 10 CF and 7 non-CF patients with MH were identified. Dilated, tortuous bronchial vessels were ubiquitous in CF, and 70% had non-bronchial collaterals. CF patients required more extensive BAE and 50% had >1 collateral. Anomalous supplies were described, and a correlation between the volume of hemoptysis and number of collaterals was determined.

Conclusion: Anomalous bronchial arteries origin and supply should be suspected in CF. Angiographic approach in CF should include arch aortograms to demonstrate entire supply of the bronchial arterial field.

Keywords: Bronchial artery embolization, cystic fibrosis, hemoptysis.

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Article Details

VOLUME: 9
ISSUE: 6
Year: 2013
Page: [402 - 406]
Pages: 5
DOI: 10.2174/1573398X10666140328222713
Price: $58

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