SELECTIVE BRONCHIAL ARTERIOGRAPHY IN DOGS.

Abstract

The nutrition of the lungs, including the bronchi, pleura, and walls of the pulmonary vessels, is supplied mainly by the bronchial arteries of the systemic circulation, and it has been demonstrated that pulmonary neoplasms, too, receive their blood from the bronchial arteries (2). The chief function of the pulmonary arteries is oxygenation of the blood, although it is stated that in dogs the blood supply to the pleura is from the pulmonary artery (1). Venous angiocardiography, pulmonary angiography, and azygos venography show distortion or obstruction of the large vessels by unresectable central extension of tumor (3), but these technics have not been of value in less advanced puhnonary tumors. Bronchial arteriography must be performed if the vascularity of pulmonary neoplasms is to be studied in the living subject. History Postmortem roentgenograms of opacified bronchial arteries in dogs have been obtained by intra-aortic injection of bismuth oxychloride (4), iodized oil (5), and barium sulfate (1). In the living dog, bronchial arteriography has been performed by thoracic aortography (6) and by surgical cannulation of the intercostal artery from which the bronchial artery arises (8). Percutaneous aortic catheterization with selective injection of the bronchial arteries would have obvious advantages over these methods. Anatomy The origin and distribution of the bronchial arteries have been studied in 150 human subjects (9). There are many variations, but most commonly one right bronchial artery arises from the first right aortic intercostal artery and two left bronchial arteries arise directly from the thoracic aorta. It should be recalled that the first, the second, and sometimes the third intercostal arteries are supplied by the subclavian artery by way of the costocervical trunk. The intercostal arteries below these arise from the thoracic aorta and are called aortic intercostal arteries. In a dissection of 30 dogs, Notkovich (10) found that the bronchial arteries to each lung were derived from the first to fourth right aortic intercostal arteries. They never arose directly from the aorta or left intercostal arteries. There was usually one, occasionally two, bronchial arteries to each lung. The left bronchial artery arose 0.5 to 5 mm. from the origin of the intercostal artery and the right bronchial artery 10 to 25 mm. from the origin of the intercostal artery. The arteries to each lung did not always arise from the same intercostal artery. Thus, bronchial arteriography could be performed in dogs by selective intercostal artery catheterization. Method A green Ödman catheter is prepared by tapering the end to an inner diameter equal to the size of a No. 120 Seldinger guide wire. The end of the catheter is molded into a short curve. In some cases a No. 120 polyethylene catheter was employed.