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

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

Volume: 9 Issue: 6

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

Affiliation:

Keywords: Bronchial artery embolization, cystic fibrosis, hemoptysis.

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.

Cite this article as:

Chakraborty Rebanta, E. Trebelev Alexander, Bianco Brian, O’Connell William, J. Stephen Michael and B. Hoag Jeffrey, Anomalous Vascular Supply of Bronchial Circulation in Cystic Fibrosis Patients with Massive Hemoptysis, Current Respiratory Medicine Reviews 2013; 9 (6) . https://dx.doi.org/10.2174/1573398X10666140328222713