Selective bronchial arteriography in the demonstration of abnormal systemic circulation in the lung

Abstract

The systemic blood supply to the lung through bronchial and intercostal arteries been investigated in 89 patients with lung disease. This has been demonstrated by thoracic aortography and selective bronchial arteriography. In many cases abnormal systemic-pulmonary shunts have been shown. These develop by the opening up of precapillary anastamoses between bronchial and pulmonary arteries. In 12 of 23 patients with bronchiectasis, two patterns emerged. In 9 instances contrast material passed freely into the peripheral pulmonary arterial tree, a phenomenon termed ‘forward flow’. In 3 patients the flow was against the normal stream in its passage towards the hilum of the lung, a situation described as ‘reverse flow’. The stress placed upon the pulmonary capillaries and the heart is considered and illustrated by individual cases. The varying systemic circulation in patients with primary lung cancer is also outlined.