Selective Bronchial and Intercostal Arteriography

ISBN-13: 9789020702378 / Angielski / Miękka / 1970 / 208 str.

A. S. J. Botenga

Opis

1. Would a better understanding of the anatomy and improvement of the method make it possible to reduce the percentage of failures sufficiently to earn selective arteriography of bronchial and intercostal arteries a place among the accepted methods of selective arteriographic investigation? 2. Can indications for such selective arteriographical investigations be formulated? The answers to these questions were considered to offer a basis for the evaluation of the clinical contribution to be expected of this method. In designing this research project, we started by making a detailed study of the radiological and anatomical literature. I I LITERATURE 11.1. PART I -RADIOLOGY Wide bronchial arteries can be demonstrated by conventional radiological methods. CAMPBELL AND GARDNER (1950), CSAKANY (1964) and KIEFFER ET AL. (1965) described characteristic pictures seen on normal X-ray's and RICHTER (1965) those seen on tomograms of the thorax. TAUSSIG (1947) and SEGERS AND BROMBART (1953) established typical impressions in the esophagus. Some of these authors, including CAMPBELL AND GARDNER (1950) and GARUSI (1961), saw wide bronchial arteries on venous angiocardiograms, but direct study of the bronchial arteries can only be done by arteriography, which still has a rather brief history. Research has been done in dogs and in man; only the latter will be discussed.

Spis treści

I. Introduction.- II. Literature.- II.1. Part I. Radiology.- II.2 Part II. Anatomy.- II.2.1. Bronchial arteries.- II.2.1.1. Historical review.- II.2.1.2. Origin of the bronchial arteries.- Critical discussion of the data in the literature.- Anatomical classification.- a. Normal origin.- The ‘normal’ anatomical situation.- a.1. Origin from the descending aorta.- Dorsal-ventral.- Cranial-caudal.- a. 2. Origin from intercostal arteries.- The occurrence of trunci communes.- Other anatomical situations.- Numbers of bronchial arteries.- b. Abnormal origin.- b.1. Origin from the aortic arch.- b.2. Aberrant origin.- Accessory bronchial arteries and anastomoses.- Normal.- Abnormal.- c. Conclusions of the data in the literature on the origin.- II.2.1.3. Central course of the bronchial arteries.- II.2.1.4. Intrapulmonary course of the bronchial arteries.- II.2.1.5. Function of the bronchial arteries.- II.2.2. Bronchial veins 24 Anastomoses 25 Discussion.- II.2.3. Intercostal arteries.- II.2.4. Intercostal veins.- III. Technique.- III. 1. Methods applied for the arteriography.- The catheterization.- The serial arteriography.- Radiography.- The contrast medium.- III.2. Comparison of aortographic and selective artériographie results.- III.3. Applications of substraction.- III.4. Conclusions.- IV. Results of the Present Study.- Material.- IV. 1. Part I. Anatomy.- IV. 1.1. Bronchial arteries.- IV. 1.1.1. Origin of the bronchial arteries.- a. Normal origin.- Normal anatomical situation.- a.1. Origin from the descending aorta.- Dorsal-ventral.- Discussion.- Conclusions.- Cranial-caudal.- a.2. Origin from intercostal arteries.- Discussion.- Bronchial arteries.- Intercostal arteries.- Conclusions.- The occurrence of trunci communes.- Discussion I.- Classification I.- Classification II.- Conclusions.- Other anatomical situations.- Discussion.- Classification I (group A).- Classification I (groups B, C D) Classification II.- ‘Normal Anatomy’.- Conclusions.- Numbers of bronchial arteries.- Discussion.- Total numbers of bronchial arteries.- Total numbers of bronchial arteries per individual.- Distribution of left and right bronchial arteries per individual.- Conclusions.- b. Abnormal origin.- b.1. Origin from the aortic arch.- Discussion.- Conclusion.- b.2. Aberrant origin.- Discussion.- Conclusion.- Accessory bronchial arteries and anastomoses.- Discussion.- Conclusion.- Level of origin of the bronchial arteries.- Discussion.- Comparison with the data of Cauldwell et al..- Comparison with the data of Viamonte et al..- Conclusions.- Range of the distribution of the bronchial origins per case.- Discussion.- Conclusion.- IV. 1.1.2. Central course of the bronchial arteries.- IV. 1.1.3. Intrapulmonary course of the bronchial arteries.- IV. 1.1.4. Function of the bronchial arteries.- Bronchi.- Esophagus.- Conclusion.- Vasa vasorum.- Vascularization of the aorta.- Vascularization of the pulmonary artery.- Hilar glands.- Trachea.- IV. 1.2. Bronchial veins.- Discussion.- Conclusions.- IV. 1.3. Intercostal arteries.- Normal origin and course.- Variants.- Anastomoses.- Anterior spinal artery.- Discussion.- Conclusions.- IV. 1.4. Intercostal veins.- IV.2. Part II. Pathology.- IV.2.1. Anastomoses.- IV.2.1.1. Broncho-bronchial anastomoses.- Literature.- Findings in arteriography.- Discussion.- Conclusions.- IV.2.1.2. Broncho-pulmonary anastomoses.- Literature.- In normal lungs.- In pathological conditions.- Discussion of the data in the literature.- Findings in arteriography.- Diagnosis.- Results.- Occurrence.- Number of shunts per case.- Width.- Localization.- Developmental course.- Discussion.- Conclusions.- IV.2.1.3. Intercosto-pulmonary anastomoses.- Literature.- Findings in arteriography.- Pulmonary anomalies with pleural adhesions.- Post-operative conditions.- Discussion.- Conclusions.- IV.2.1.4. Intercosto-bronchial anastomoses.- Literature.- Findings in arteriography.- Discussion I.- Conclusion.- IV.2.2. Bronchial vascularization in pulmonary diseases.- IV.2.2.1. Tumors.- Literature.- Findings in arteriography.- Localization and vascularized part of the tumor.- Relation to the histological findings.- Hilus.- Transpleural vascularization.- Metastases.- Hamartoma.- Pleural tumors.- Irradiation.- Discussion.- Conclusions.- Indications.- IV.2.2.2. Tuberculosis.- Literature.- Findings in arteriography.- Old fibrotic and fibrocaseous lesions.- Active fibrocaseous and caseous lesions.- Extensive exudative caseous tuberculous lesions with or without cavities.- Tuberculoma.- Remarks.- Discussion.- Conclusions.- IV.2.2.3. Bronchiectasis.- Literature.- Findings in arteriography.- Type of the bronchiectasis.- Severity of the changes.- Quotient of the surface of the cross-section of the bronchial arteries in mm2 and the number of bronchiectatic segments.- Broncho-pulmonary anastomoses.- Localization of broncho-pulmonary anastomoses.- Broncho-bronchial anastomoses.- Tortuosity.- Penetration.- Formation of new vessels.- Abrupt narrowing.- Hilar glands.- Condition of the patient.- Discussion.- Conclusions.- IV.2.2.4. Emphysema.- Literature.- Resumé.- Findings in arteriography.- Discussion.- Conclusions.- IV.2.2.5. Other lesions.- Chronic infiltration.- Chronic asthmatic bronchitis.- Infected cavities.- Diffuse small focal lesions.- Bronchoplasty.- Aspergillosis.- Hemoptysis.- Pleural tumors.- Bronchogenic cyst.- Suppurative pneumonia.- Histiocytosis X.- Subphrenic abscess.- Esophageal carcinoma.- IV.2.3. The bronchial circulation in heart disease.- Tetralogy of Fallot.- Literature.- Findings in arteriography.- General observations.- Case analysis.- Patient 7/.- Discussion and conclusions.- Patient 2.- Discussion and conclusions.- Patient 3.- Discussion and conclusions.- Patient 4.- Discussion and conclusions.- Conclusion.- V. General considerations.- V.1. Success and failure of arteriography.- V.2. Indications.- V.2.1. For bronchial arteriography.- V.2.2. For intercostal arteriography.- V.2.3. For bronchial and intercostal arteriography.- V.3. Contra-indications and factors with an undesirable influence.- V.4. Complications.- V.4.1. Untoward effects for the patient.- V.4.1.1. Non-specific complications.- V.4.1.2. Specific complications.- V.4.2. Spasms and other artificial phenomena.- V.4.2.1. Effect of novocaïne.- V.4.2.2. Other artefacts.- V.4.3. The chance of spinal-cord lesions.- Literature.- Anatomy.- Arteriography.- Data from our material.- Discussion.- V.4.4. Conclusions.- Summary.- References.- Appendix: Tables 1 to 13 in cover.