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Congress: ECR24
Poster Number: C-15889
Type: EPOS Radiologist (educational)
DOI: https://dx.doi.org/10.26044/ecr2024/C-15889
Authorblock: A. Antony, N. P. Mangali, M. Vimal Chacko, S. K. Deepalam; Bangalore/IN
Disclosures:
Dr. Amal Antony: Nothing to disclose
Dr. Navya Paulson Mangali: Nothing to disclose
Dr. Mondy Vimal Chacko: Nothing to disclose
Dr. Sai Kanth Deepalam: Nothing to disclose
Keywords: Arteries / Aorta, Emergency, Interventional vascular, Catheter arteriography, CT-Angiography, CT-High Resolution, Balloon occlusion, Contrast agent-intravenous, Stents, Aneurysms, Arteriovenous malformations, Obstruction / Occlusion
Learning objectives To elucidate and classify the uncommon vascular sources of haemoptysis. To describe their distinctive imaging characteristics. To detail the role of interventional radiology in their management
Read more Background Haemoptysis is defined as the expectoration of blood from the lung parenchyma or airways [1]. It poses a diagnostic challenge, necessitating utilisation of imaging for accurate identification of the source of bleeding. Multidetector CT angiography (MDCTA) is the imaging modality of choice, offering a comprehensive assessment of lung parenchyma, thoracic vasculature, and soft tissues. It accurately identifies the source of hemoptysis, thereby aiding in planning appropriate interventions. The role of endovascular interventions is becoming increasingly significant, serving as an effective and...
Read more Findings and procedure details Common Vascular Source of hemoptysis: Orthotopic bronchial arteries Orthotopic bronchial arteries have their origins in the proximal descending aorta between the superior endplate of T5 and the inferior endplate of T6. The right bronchial artery can share an origin with an intercostal artery, forming an intercostal-bronchial artery trunk. A common bronchial trunk may be seen occasionally. The branching patterns of bronchial arteries, as outlined by Cauldwell et al., exhibit significant variability [3].   [fig 1] [fig 2] [fig 3] [fig 4]  Uncommon Vascular Sources of hemoptysis The uncommon vascular sources...
Read more Conclusion Although the vast majority of patients who present with haemoptysis have an underlying bronchial source, atypical vascular sources of haemoptysis have to be looked for before planning management. Failure to identify these before intervention may result in persistent or recurrence of haemoptysis.  MDCTA can accurately detect and identify these uncommon sources, thereby aiding in subsequent management. Endovascular intervention has become the preferred treatment approach for patients with haemoptysis stemming from uncommon vascular sources.   The radiologist plays a central role in the multidisciplinary...
Read more References Earwood JS, Thompson TD. Hemoptysis: evaluation and management. American family physician. 2015 Feb 15;91(4):243-9. Jean-Baptiste E. Clinical assessment and management of massive hemoptysis. Crit Care Med. 2000;28:1642–1647. Cauldwell EW, Siekert RG, et al. The bronchial arteries; an anatomic study of 150 human cadavers. Surg Gynecol Obstet. 1948;86:395–412 Tanomkiat W, Tanisaro K. Radiographic relationship of the origin of the bronchial arteries to the left main bronchus. J Thorac Imaging. 2003;18:27–33. Hartmann Ieneke J. C., Remy-Jardin Martine, Menchini Laura, Teisseire Antoine, Khalil Chadi, Remy Jacques. Ectopic origin of bronchial arteries:...
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