A young man with tuberculosis presents with massive recurrent hemoptysis. For angiographic treatment which vascular structure should be evaluated first?
Answer is B (Bronchial Aery): Diagnosis and treatment of symptoms of Respiratory; Vascular and Interventional Radiology by bakal (2002)/158 Hemoptysis usually arises from the bronchial aeries. Pulmonary aeries are a rare source of hemorrhage. The vascular structure that should be evaluated .first for angiographic treatment are therefore bronchial aeries. `Majority of cases of hemoptysis represent bleeding from the bronchial aeries, therefore bronchial angiography is usually the initial angiographic procedure'-Diagnosis and Treatment of symptoms of the Respiratory Tract (2007)/177 90% cases)" align="left" height="39" width="235">A pulmonary aerial source should be considered in addition to the more common systemic source (bronchial aery) in the setting of destructive lung lesion such as cavitatory tuberculosis. However the vascular structure that should be evaluated first is the bronchial aery. Remember : Ramussen Aneurysm Ramussen aneurysm is a rare cause of bleeding in cavitatory tuberculosis and results from erosion of tuberculous cavity into a pulmonary aery branch. The most common source of bleeding in Retnussen aneurysm is the pulmonary aerydeg.
Pulmonary aery
Bronchial aery
Pulomary vein
Superior vena cava