Bronchial artery embolization

Bronchial artery embolization. This 31 year old patient with cystic fibrosis presented with massive, life-threatening haemoptysis. In this scenario, the bleeding source is usually one of the bronchial arteries, which arise directly from the aorta on the left and from one of the intercostal arteries on the right. A catheter was inserted through the right femoral vein and positioned in the aortic arch (left image, yellow arrows). Contrast was injected through this in order to determine the origins of the bronchial arteries, and showed a hugely dilated right bronchial artery (orange arrow), which was presumed to be the source of the haemorrhage. A microcatheter was then manipulated into this artery, taking a convoluted course through the tortuous vessel (white arrows on right-hand image). The artery was embolized and the patient’s haemoptysis resolved.