Ectopic Bronchial Arteries – Incidental Findings on Multi-detector Computed Tomography

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Introduction: Orthotopic bronchial arteries (BAs) arise from the descending aorta between T5 and T6 vertebral levels and those emanating from the aortic arch, distal descending aorta, and subclavian arteries are called ectopic and are present in about one-third of cases. Study Design: Rare and unreported origin of ectopic BAs incidentally detected while analyzing 710 multi-detector computed tomography (MDCT) scans are presented. Observations: Ectopic BAs of subclavian origin supplying ipsilateral lungs are seen in two cases. Ectopic common bronchial trunk arising from the left subclavian and dividing into right and left branches was observed in two cases. Bilateral subclavian origin of both BAs is a rare presentation. Till now, an unreported variant is the common trunk of the left bronchial and left vertebral (bronchovertebral trunk) arising from the left subclavian close to its root from the aortic arch. Another rare variant of right bronchial arising from the left subclavian (Contralateral origin) is also noted. Discussion and Conclusion: The number of BAs varies. At least one ectopic BA is present in 36% of cases and in nearly half of these cases, ectopic arteries are the only supply. BAs are embolized to control severe hemoptysis and are used for infusion chemotherapy for lung neoplasms. A prerequisite for successful interventional and surgical procedures on BA is precise anatomical knowledge and preprocedural MDCT can provide accurate anatomical information to prevent complications following BA embolization to control hemoptysis.