Bronchial Artery Research Articles

Bronchial artery embolization leading to acute myocardial infarction: a case report on bronchial artery-coronary artery fistula

A 22-year-old woman presented with hemoptysis for three days, averaging 150 ml of blood per day. She had no history of childhood chest disease. On admission, a chest scan suggested a potential lung infection, and laboratory results showed no significant abnormalities. Despite continuous infusion of posterior pituitary hormone, her symptoms persisted. We performed bronchial arteriography and embolization using 150–350 μm microsphere particles. During the procedure, the patient developed chest pain. An electrocardiogram (ECG) showed abnormal Q-waves and ST-T elevation, with vital signs indicating hypotension and elevated myocardial enzymes suggesting acute myocardial infarction (AMI). Repeated arteriography revealed a bronchial artery-right coronary artery fistula, likely worsened by a dislodged gelatin sponge blocking coronary microvessels. The embolization was halted, and treatment with low molecular weight heparin and aspirin was initiated. By the fifth postoperative day, the patient’s ECG indicated an abnormal Q wave in the inferior leads, and myocardial enzymes were gradually returning to normal. One week later, coronary angiography revealed no blockage, and the patient was discharged after stabilization. The cardiovascular magnetic resonance (CMR) indicated myocardial necrosis and edema in the inferior wall of the heart. During subsequent follow-up, the patient reported no significant chest pain or recurrence of hemoptysis.

Efficacy and safety of CalliSpheres drug-eluting bead bronchial arterial infusion chemoembolization vs. bland embolization in advanced lung cancer with hemoptysis: A multicenter retrospective study.

Massive hemoptysis is a life-threatening complication in patients with advanced primary lung cancer, and effective, safe treatments are crucial. This study aimed to investigate the efficacy and safety of CalliSpheres drug-eluting bead bronchial arterial infusion chemoembolization (DEB-BACE) for managing this condition. A retrospective analysis included 144 patients with advanced primary lung cancer and massive hemoptysis treated at multiple hospitals from January 2019 to January 2023. Patients undergoing bronchial artery embolization were divided into two groups: the observation group (n=76) received CalliSpheres DEB-BACE with epirubicin, and the control group (n=68) received 8spheres blank embolization. Both groups achieved successful hemostasis, with no statistically significant difference in success rates (observation group: 88.16%, control group: 86.76%). However, the observation group had a significantly longer median duration without hemoptysis (96 days vs. 50 days). Two months post-therapy, the observation group showed higher objective response rates (82.89% vs. 38.24%) and disease control rates (92.11% vs. 66.18%) compared to the control group. Adverse reactions were manageable and similar between groups, with no serious complications observed. By January 31, 2024, the observation group had significantly longer median overall survival (11 months vs. 7 months). The DEB-BACE treatment demonstrates safety and efficacy in managing massive hemoptysis in patients with advanced lung cancer. However, the superiority of this approach over bland embolization remains to be established through well-designed prospective studies. Future research is anticipated to provide a definitive comparison and further validate the role of DEB-BACE in clinical practice.

Bronchial Artery Aneurysm with Anomalous Origin from the Left Circumflex Coronary Artery.

Bronchial Artery Aneurysm with Anomalous Origin from the Left Circumflex Coronary Artery.

Preliminary investigation of the significance of cavitary lesions in recurrent hemoptysis following bronchial artery embolization for nontuberculous mycobacterial pulmonary disease

BackgroundNontuberculous mycobacterial pulmonary disease (NTM-PD) varies widely in clinical presentation, and some patients experience hemoptysis. Bronchial artery embolization (BAE) is a treatment option for hemoptysis caused by NTM-PD. However, the association between post-BAE rebleeding risk and the presence of cavitary lesions has not been fully elucidated. MethodsA retrospective observational study was conducted on patients with NTM-PD who had undergone BAE at our institution. Patients were classified into Cavitary and Non-cavitary groups, and baseline characteristics and clinical outcomes were compared. ResultsAmong the 155 BAE cases between 2013 and 2023, 18 were included in the analysis, and four experienced rebleeding. The Cavitary group tended to have a higher rebleeding rate 24 months after BAE (37.5% vs. 10.0%, p = 0.27). Furthermore, the Cavitary group showed a significantly higher number of non-bronchial arteries involved (median number: 1.5 vs. 0.0, p = 0.02), a higher proportion of patients with a prior antibiotic treatment history (100% vs. 20%, p = 0.001), and longer duration from diagnosis to BAE (median year: 9.0 vs. 0.6, p = 0.02). The Kaplan-Meier curves showed a tendency for shorter rebleeding-free survival in the Cavitary group (p = 0.10). ConclusionsCavitary lesions in patients with NTM-PD may predict higher rebleeding rates after BAE. Further research with larger cohorts is needed to better understand rebleeding risk factors in BAE for NTM-PD.

Feasibility and Safety of the Distal Transradial Access for Noncardiac Intervention.

Distal transradial access through the anatomical snuffbox has been highlighted in recent research because it provides extremely low invasiveness. It has demonstrated its feasibility and safety for cardiac intervention. However, its characteristics for noncardiac intervention are not well known. This report aims to demonstrate the feasibility and safety of noncardiac intervention with distal transradial access, with identification of practical devices for procedures. This retrospective study was conducted from May 2021 to December 2021 with consecutive patients who underwent distal transradial access for noncardiac intervention. This study analyzed patient physical information, procedural details, technical success rates, and distal transradial access-associated complications. Nine patients (7 females, 2 males) aged 48-69 years (median: 57) were enrolled in this study. This study assessed 11 noncardiac procedures, such as transarterial infusion chemotherapy for head and neck malignancies (n = 4), embolization of visceral artery aneurysm (n = 2), embolization of renal angiomyolipoma (n = 2), percutaneous transluminal renal angioplasty (n = 1), bronchial artery embolization (n = 1), and diagnostic angiography (n = 1). The introducer sheath size was 4-6 French. Catheters respectively having nine tip shapes were used. Reverse curve catheters were used only in two cervical procedures. The technical success rate was 91% (10/11). Of the 11 procedures, only 1 (bronchial artery embolization) required conversion to transfemoral access. There was no complication associated with distal transradial access. Ultrasound evaluation after treatments revealed patent radial arteries in all patients. Results revealed that distal transradial access is feasible with commercially available catheters and is safe for various noncardiac interventions.

Rasmussen's Aneurysm: A Rare Cause of Massive Hemoptysis in Pulmonary Tuberculosis

Rasmussen's aneurysm is a rare cause of hemoptysis in patients with tuberculosis. It is an under-recognised vascular complication of active pulmonary tuberculosis, with a mortality rate of over 50%. It is secondary to an aneurysmal dilatation of the pulmonary artery adjacent to tuberculous cavity. Thoracic CT angiography is the gold standard for making a positive diagnosis and precising the hemorrhagic site, with a mapping of the pulmonary artery damage. Rupture of the artery can cause massive hemoptysis, which can sometimes be devastating. It is important to remember that hemoptysis persists despite successful bronchial artery embolisation in all patients with tuberculosis.

Improving culprit artery identification with intraprocedural cone-beam CT aortography and its clinical impact in bronchial artery embolization.

To evaluate the impact of intraprocedural cone-beam CT (CBCT) aortography on culprit artery identification and clinical outcomes in patients undergoing bronchial artery embolization (BAE). Two hundred eighty-two patients with 317 BAE procedures were retrospectively reviewed. Patients who underwent preprocedural chest CT angiography (CTA) without intraprocedural CBCT aortography were categorized as Group A (n = 177). Patients who underwent both preprocedural chest CTA and intraprocedural CBCT aortography were categorized as Group B (n = 105). Whether CBCT can provide improved culprit artery identification and whether this improvement has a clinical impact were evaluated by comparing the two Groups. In Group B, CBCT aortography detected more culprit non-bronchial systemic arteries originating from the subclavian arteries compared to chest CTA (16 vs 3, p = 0.026), and the average number of embolized vessels was significantly higher than in Group A (2.47 ± 1.61 vs 2.03 ± 1.17, p = 0.016), while the procedure time was shorter (37.4 ± 22.0 vs 43.6 ± 22.7 min, p = 0.024). The recurrent hemoptysis rate was lower in Group B (17.5% vs 8.7%, p = 0.041), and the proportion of patients requiring subsequent procedures was significantly lower (12.4% vs 4.8%, p = 0.035). The changes in estimated glomerular filtration rate before and 3 days after the procedure (0.1 ± 12.8 vs 0.3 ± 11.0 mL/min/1.73 m2, p = 0.909) and total dose area product (DAP, 6119.5 ± 5725.7 vs 6906.2 ± 5978.6 uGym2, p = 0.279) were not significantly different between the two groups. BAE with intraprocedural CBCT aortography enabled the embolization of more culprit arteries, leading to lower recurrent hemoptysis rates without increasing the risk of renal deterioration and radiation hazards when compared to procedures without it. Question Does intraprocedural CBCT aortography improve culprit artery detection and clinical outcomes in BAE for hemoptysis? Findings CBCT aortography significantly improved the detection of additional culprit arteries, especially from non-bronchial systemic arteries, increasing the number of vessels treated during BAE. Clinical relevance Using CBCT aortography during BAE results in better long-term outcomes by reducing recurrent hemoptysis and the need for additional procedures, without increasing the risk of renal impairment.

Multi-drug resistant Pseudomonas aeruginosa isolation is an independent risk factor for recurrent hemoptysis after bronchial artery embolization in patients with idiopathic bronchiectasis: a retrospective cohort study

BackgroundCurrently, there is a lack of research on multi-drug resistant Pseudomonas aeruginosa (MDR-PA) isolation in bronchiectasis-related hemoptysis. The aim of this study to analyze the risk factors for recurrent hemoptysis following bronchial artery embolization (BAE) and compare the recurrent hemoptysis-free rates between MDR-PA, non-MDR-PA, and non-PA isolation.MethodsA retrospective study was performed of patients diagnosed with idiopathic bronchiectasis-related recurrent hemoptysis who underwent BAE at an university-affiliated hospital. Patients were categorized based on PA susceptibility tests into non-PA, non-MDR-PA, and MDR-PA groups. Univariate and multivariate Cox regression were conducted to identify independent risk factors for recurrent hemoptysis. The Kaplan-Meier curves was conducted to compare recurrent hemoptysis-free rates after BAE for non-PA, non-MDR-PA, and MDR-PA.ResultsA total of 432 patients were included. 181 (41.90%) patients experienced recurrent hemoptysis during a median follow-up period of 25 months. MDR-PA isolation (adjusted hazard ratio (aHR) 2.120; 95% confidence interval (CI) [1.249, 3.597], p = 0.005) was identified as an independent risk factor for recurrent hemoptysis. Antibiotic treatment (aHR 0.666; 95% CI [0.476, 0.932], p = 0.018) reduced the risk of recurrent hemoptysis. The cumulative recurrent hemoptysis-free rates for non-PA, non-MDR-PA, and MDR-PA were as follows: at 3 months, 88.96%, 88.24%, and 75.86%, respectively; at 1 year, 73.13%, 69.10%, and 51.72%; and at 3 years, 61.91%, 51.69%, and 41.10% (p = 0.034).ConclusionMDR-PA isolation was an independent risk factor of recurrent hemoptysis post-BAE. Reducing the occurrence of MDR-PA may effectively decrease the recurrence rates of hemoptysis.

Consolidation in the right middle lobe in pediatric bronchial-pulmonary artery shunt: radiology's Aunt Minnie?

By retrospectively studying the chest computed tomography (CT) data of children with bronchial artery (BA)-pulmonary artery fistula, this study summarizes the characteristic imaging features of the disease and provides imaging support for the diagnosis and clinical treatment of these children. Digital subtraction angiography and CT angiography data were collected from 74 children with pulmonary hemorrhage following BA embolization. Bronchial-pulmonary shunt was present in 30 cases. Of the 74 children with pulmonary hemorrhage in this study, seven exhibited signs of consolidation in the middle lobe of the right lung, and bronchial-pulmonary shunt existed in all of them. A total of 30 children with BA-pulmonary artery shunt (PAS) had BA tortuosity and thickening. Regarding primary BA-PAS, the middle lobe and lower lobe of the right lung were involved in 94.1% (16) of the children. Those with a fistula located in the middle lobe of the right lung accounted for 58.8% (10 cases), of which 40.0% (four cases) presented consolidation. In this study, 41.2% (seven) of the children with primary BA-PAS exhibited no abnormal changes on chest CT, and 58.8% (10 cases) exhibited abnormal changes in the unilateral lung. For children with pulmonary hemorrhage who have consolidation in the right middle lobe, the formation of BA-PAS should be anticipated. The possibility of primary BA-PAS should not be disregarded in children with pulmonary hemorrhage with tortuosity and dilation of BAs, despite no apparent abnormalities on lung CT, or ground-glass density or consolidation on only one side. The chest CT of patients with pulmonary hemorrhage showed consolidation of the right middle lobe of the lung, which was highly likely to indicate BA-PAS.

Case Report : Undifferentiated Synovial Sarcoma Presenting as a Large Thoracic Mass: A Rare and Challenging Diagnosis

Background: Undifferentiated synovial sarcoma (USS) is a rare and aggressive subtype of soft tissue sarcoma. Its presentation as a large thoracic mass poses significant diagnostic and therapeutic challenges.  Case Presentation: A 34-year-old male presented with a three-month history of progressive chest pain and hemoptysis. Imaging studies revealed a large, cystic thoracic mass with pleural effusion. Initial serological testing suggested hydatid cyst, but subsequent testing revealed negative Echinococcus (Hydatid) IgG antibodies.  Diagnostic and Therapeutic Interventions: Repeat fine-needle aspiration cytology (FNAC) was deferred due to revised ultrasound findings indicating a solid fibrocystic vascular lesion. Bronchial artery embolization (BAE) was performed to control life- threatening hemorrhage. Thoracotomy and en-bloc mass excision were subsequently undertaken.  Histopathological Diagnosis: Histopathological examination of the resected specimen revealed undifferentiated synovial sarcoma and spindle cell sarcoma.  Clinical Implications: This case highlights the importance of correlating imaging and serological findings, managing vascular complications, and the efficacy of BAE in controlling hemorrhage. The significance of thoracotomy and mass excision in achieving diagnostic clarity and therapeutic success is underscored.  Conclusion: Undifferentiated synovial sarcoma presenting as a large thoracic mass poses significant diagnostic and therapeutic challenges. A multidisciplinary approach, incorporating imaging, serological testing, and surgical intervention, is crucial for achieving optimal patient outcomes.

Perfusion Patterns of Peripheral Pulmonary Metastasis Using Contrast-Enhanced Ultrasound (CEUS) and Their Correlation with Immunohistochemically Detected Vascularization Pattern.

Description of the perfusion of pulmonary metastasis by contrast-enhanced ultrasound (CEUS) and their correlation with vascularization patterns represented by immunohistochemical CD34 endothelial staining. The data of 54 patients with histologic proven peripheral pulmonary metastasis, investigated between 2004 and 2023 by CEUS. These CEUS parameters were evaluated: time to enhancement (TE), categorized as early pulmonary-arterial (PA) or delayed bronchial-arterial (BA) patterns; extent of enhancement (EE), either marked or reduced; homogeneity of enhancement (HE), homogeneous or inhomogeneous; and decrease of enhancement (DE), rapid washout (<120 s) or late washout (≥120 s). Additionally, tissue samples in 45 cases (83.3%) were stained with CD34 antibody for immunohistochemical analysis. In total, 4 lesions (7.4 %) exhibited PA enhancement, and 50 lesions (92.6%) demonstrated BA enhancement. Furthermore, 37 lesions (68.5%) showed marked enhancement, while 17 lesions (31.5%) exhibited reduced enhancement. The enhancement was homogeneous in 28 lesions (51.86%) and inhomogeneous in 26 lesions (48.14%). Additionally, 53 lesions (98.1%) displayed a rapid washout. A chaotic vascular pattern indicative of a bronchial arterial blood supply was identified in all cases (45/45, 100%), including all 4 lesions with PA enhancement. Pulmonary metastases in CEUS predominantly reveal bronchial arterial enhancement and a rapid washout. Regarding EE and HE, pulmonary metastases show heterogeneous perfusion patterns. A PA enhancement in CEUS does not exclude BA neoangiogenesis.

Prospective Comparison of Conventional CTA With Angiography-CT for Identification of Culprit Systemic Arteries in Patients Undergoing Bronchial Artery Embolization for Hemoptysis.

Prospective Comparison of Conventional CTA With Angiography-CT for Identification of Culprit Systemic Arteries in Patients Undergoing Bronchial Artery Embolization for Hemoptysis.

The efficacy, safety, and related factors of bronchial artery embolization for hemoptysis: a systematic review and meta-analysis with subgroup analysis.

Bronchial artery embolization (BAE) is a common and important way to manage hemoptysis. This study's purpose was to summarize the efficacy, safety, and related factors of BAE in the treatment of hemoptysis. From January 2010 to August 2023, a systematic literature search was conducted in PubMed, EMBASE, Web of Science, and Cochrane Library databases. Original studies with BAE for hemoptysis were included, with no restrictions on language. The outcomes of interest were technical success rate, clinical success rate, recurrence rate, mortality rate, and major complication rate. Pooled proportions with 95% confidence intervals (CIs) were calculated using random-effects models. The Newcastle-Ottawa Scale (NOS) was employed for quality assessment. Factors such as publication year, region, sample size, amount of hemoptysis, etiology, and embolization materials were extracted for subgroup analyses. Additionally, sensitivity analyses and test for publication bias were conducted. A total of 32 studies, including 6,032 patients, met our inclusion criteria. 27 studies were of high quality, while five of moderate quality. The results indicated the prevalence of technical success was 97.2% (95% CI: 95.1-98.8%) and 93.2% (95% CI: 90.3-95.7%) in clinical success. Hemoptysis recurrence and mortality rates after BAE were 24.8% (95% CI: 20.5-29.4%) and 2.3% (95% CI: 1.1-3.8%), respectively. Moreover, the pooled prevalence of major complication was 0.1% (95% CI: 0.0-0.4%). Subgroup analysis revealed that studies published after 2017 demonstrated a higher technical success rate and a lower recurrence rate. Massive hemoptysis showed a higher technical success rate but a lower clinical success rate. BAE also demonstrated superior efficacy in patients with bronchiectasis. The clinical success rate was significantly higher in patients with benign diseases than those with malignancies. Gelatin sponge (GS) showed poor embolization efficacy. N-butyl-2-cyanoacrylate (NBCA) and coils exhibited reduced recurrence rates, while NBCA displayed an even lower recurrence rate than non-absorbable particles. The study by Ishikawa et al. influenced the stability of the pooled major complication rate, and the sensitivity analysis confirmed the robustness of the remaining results. BAE is safe and effective in treating different degrees of hemoptysis caused by benign and malignant lesions. Promising clinical efficacy was observed with NBCA as an embolic material for the treatment of hemoptysis. However, further conclusions should be investigated using evidence-based medicine.

Controversies in the clinical management of chronic pulmonary aspergillosis.

Chronic pulmonary aspergillosis has a range of manifestations from indolent nodules to semi-invasive infection. Patients may be asymptomatic or have chronic symptoms such as cough and weight loss or present with life-threatening haemoptysis. The physician can choose from a range of available therapies including medical therapy with antifungals, minimally invasive therapy with intracavitary antifungal therapy and surgery involving open thoracotomy or video-assisted thoracoscopic surgery. The patients with the most severe forms of pulmonary infection may not be surgical candidates due to their underlying pulmonary condition. The management of haemoptysis can include tranexamic acid, bronchial artery embolisation, antifungals or surgery. There are few controlled studies to inform clinicians managing complex cases, so a multidisciplinary approach may be helpful.

559. SURGICAL PROCEDURE AND CLINICAL OUTCOME OF TRANSMEDIASTINAL ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

Abstract Background We started performing esophagectomy by a laparoscopic transhiatal approach in 2009, and 577 patients had undergone to date. Furthermore, we started performing single-port mediastinoscopic cervical approach in 2014, and developed a technique for total mediastinal lymph node dissection (390 patients). Methods The upper and middle mediastinal lymph node dissection including lymph nodes along the left recurrent laryngeal nerve, using a left cervical approach, was performed with a single-port mediastinoscopic technique. This approach with pneumomediastinum by AirSeal System improved the visibility and handling in the deep mediastinum around the aortic arch. We recently performed intraoperative monitoring of the recurrent laryngeal nerve using Nerve Integrity Monitor system. For dissection of upper and middle mediastinal lymph nodes, the left recurrent laryngeal nerve was sometimes compressed by the shaft of the sealing device or the retractor. We used continuous monitoring with the Automatic Periodic Stimulation electrode for the left recurrent laryngeal nerve, and immediately recognized dangerous procedures. Frequency of recurrent laryngeal nerve palsy was dramatically reduced to half by the introduction of Nerve Integrity Monitor system. Furthermore, to understand the anatomy of bilateral bronchial arteries, we performed 3-dimensional computed tomography angiography preoperatively, which was crucial to avoid intraoperative bleeding. Results The outcome of patients performed transmediastinal radical esophagectomy was compared with those performed the right thoracotomy by using propensity score matching. The operative time, the operative bleeding, and postoperative respiratory complications were significantly decreased by transmediastinal radical esophagectomy. Conclusion Our surgical procedure resulted in a good surgical view, safe en-bloc mediastinal lymph node dissection, and the decrease of postoperative respiratory complications. https://intconferenceservices-my.sharepoint.com/:v:/g/personal/barbarav_icsevents_com/ER9oAGbon3xJvdMGlJ2EUbIBgaq_8XDlKNA-wzVH3-7Hcg?nav=eyJyZWZlcnJhbEluZm8iOnsicmVmZXJyYWxBcHAiOiJPbmVEcml2ZUZvckJ1c2luZXNzIiwicmVmZXJyYWxBcHBQbGF0Zm9ybSI6IldlYiIsInJlZmVycmFsTW9kZSI6InZpZXciLCJyZWZlcnJhbFZpZXciOiJNeUZpbGVzTGlua0NvcHkifX0&amp;e=KbAfDr

1336P Clinical outcomes, toxic effect, and changes of immune microenvironment of drug-eluting beads bronchial artery chemoembolization (DEB-BACE) combined with immunotherapy in the treatment of elder patients with non-small cell lung cancer

1336P Clinical outcomes, toxic effect, and changes of immune microenvironment of drug-eluting beads bronchial artery chemoembolization (DEB-BACE) combined with immunotherapy in the treatment of elder patients with non-small cell lung cancer

1481P A case-control study of drug-eluting microspheres and blank microspheres in bronchial artery embolization for hemoptysis in non-small cell lung cancer

1481P A case-control study of drug-eluting microspheres and blank microspheres in bronchial artery embolization for hemoptysis in non-small cell lung cancer

Selective embolisation of an idiopathic bronchial artery pseudoaneurysm presenting with recurrent laryngeal nerve palsy: a case report

BackgroundBronchial artery pseudoaneurysms (BAP) or aneurysms (BAA) are rare, potentially life-threatening and remain poorly understood. They are most commonly idiopathic but may be associated with a number of other disease processes. Bronchial artery embolisation (BAE) is considered the first line treatment while surgical techniques are reserved for patients with a clear contraindication to embolisation or where anatomical factors preclude an endovascular approach.Case presentationWe present an interesting case of a 56 year-old male presenting with an idiopathic unruptured right BAP causing clinical and radiological signs of left recurrent laryngeal nerve (RLN) palsy. He was otherwise clinically well with no other reported symptoms and no significant past medical history. There were no significant findings on work-up and investigation. He was ultimately treated successfully with selective transarterial coil embolization of the right bronchial artery. This is an atypical presentation of a rare clinical entity and has not previously been published in the literature to our knowledge.ConclusionsBAPs and BAAs are highly variable in their presentation, ranging from incidental asymptomatic findings to catastrophic haemorrhage, depending on their location and if they are contained or ruptured. Timely diagnosis and referral to facilitate urgent embolisation is essential to prevent potentially serious clinical sequelae. Endovascular treatment in the form of BAE is considered first line.

Pediatric hemoptysis: diagnostic and interventional challenges.

Hemoptysis in the pediatric population, while infrequent, poses significant challenges for both the family and healthcare practitioners. The severity of hemoptysis dictates management decisions. Most cases being mild and self-limiting are treated conservatively. However, "life-threatening hemoptysis" may occur, and is defined as any degree of blood loss that endangers the airway and is arbitrarily considered to be > 8ml/kg in 24h in children. It requires prompt airway management and resuscitation followed by a tailored approach consisting of bronchoscopy, computed tomography (CT), interventional radiology, and/or surgery depending on the patient 's clinical status and cardiopulmonary comorbidities. Bronchial arteries are hypertrophied in myriad conditions and account for 90-95% cases of hemoptysis due to their systemic pressure levels; the rest being contributed by pulmonary artery pathologies. Despite similar pathogenic mechanisms, the etiologies of pediatric hemoptysis differ from those in adults, with acute lower respiratory tract infections being the predominant cause. Imaging plays a crucial role in identifying the source and cause of hemorrhage. Multidetector computed tomography (MDCT) has emerged as a prime modality in the diagnostic evaluation of hemoptysis and provides a roadmap for potential interventional procedures. This article discusses the etiopathogenesis of hemoptysis along with a brief mention of the diagnostic modalities. It provides a structured reporting format and uses it to illustrate the imaging features in hemoptysis, with emphasis on CT angiography. The key findings in the lung parenchyma, airways, bronchial and non-bronchial systemic collaterals, and pulmonary arteries are elaborated upon. It further addresses the nuances of interventional management, particularly emphasizing the applications of bronchial artery embolization and pulmonary artery embolization in the pediatric population. The article also underscores the potential complications and factors influencing recurrence rates.

Delayed Diagnosis and Successful Glue Embolization of a Post-Traumatic Bronchial Artery Pseudoaneurysm: A Case Report.

Bronchial artery pseudoaneurysms (BAPs) are rare but potentially fatal vascular anomalies. We present a case of a 21-year-old male soldier who developed a BAP following a fall sustained during a suicide attempt. The BAP was identified on computed tomography angiography (CTA) and successfully treated with trans-arterial glue embolization. The patient's recovery was uncomplicated. To our knowledge, only one prior case of post-traumatic BAP treated with endovascular intervention has been reported in the literature (29 years ago). Due to the risk of significant morbidity and mortality associated with BAP rupture, prompt diagnosis and treatment are crucial. Endovascular embolization is a safe and effective treatment option for BAPs. This case highlights the effectiveness of glue embolization as a treatment modality for BAPs.