Bronchial arteriography is an invasive contrast radiography of the bronchial arterial bed. It is carried out in an X-ray operating room, informative for identifying the source and causes of pulmonary bleeding, congenital vascular anomalies. With bronchial arteriography, puncture and catheterization of the femoral artery is performed, retrograde catheter insertion into the aorta to the mouth of the bronchial artery under X-ray control. After contrasting the artery with iodine preparations, angiograms are performed. Visualization of aneurysmal extensions, thrombosis, hypervascularization, and contrast beyond the vessel limits allow us to clarify the nature of the pathology.
Indications of bronchial arteriography
pulmonary bleeding of unclear etiology and localization.
- severe atherosclerosis;
- obesity of the patient;
- pulmonary-heart failure.
Method of conducting
It is performed under local anesthesia and X-ray control. television. With a special needle with a mandrel, the femoral artery is punctured below the inguinal fold. The mandrel is replaced with a metal conductor, through which an X-ray contrast catheter with a curved end is inserted into the lumen of the artery. Then the conductor is removed, the catheter is inserted into the aorta, the tip of the catheter is found at the mouth of the bronchial arteries and a catheter and a contrast agent (hypac, urographin, urotrast) 5-12 ml are inserted into them and serial radiography is performed.
Arteriograms can reveal
- dilation and pathological tortuosity of the bronchial arteries
- the output of the contrast agent beyond the limits (extravasation);
- focal and diffuse hypervascularization;
- bronchial artery aneurysms;
- bronchial artery thrombosis;
- retrograde filling of the peripheral branches of the pulmonary artery through
- arterioarterial anastomoses.
Complications of bronchial arteriography
- hematoma in the area of puncture of the femoral artery;
- vascular lesions of the spinal cord with impaired