Subclavicular angiography with brachial-axillary artery externally and temporally occluded in interventional treatment of hemoptysis

Objective: To evaluate subclavicular angiography with brachial-axillary artery externally and temporally occluded in depicting hemoptysis-related ectopic arteries originating from shoulder, neck and chest wall in the interventional treatment of hemoptysis. Methods: A retrospective analysis of the medical records and angiograms of 103 patients who underwent transarterial procedures for hemoptysis was carried out. The arteries originating from the subclavicular arteries supplying the shoulder, the neck and the chest wall, ectopic bronchial arteries (EBA) as well as non bronchial systemic arteries (NBSA), were depicted by subclavicular angiography with brachial-axillary artery externally and temporally occluded. The number and distribution of the responsible aberrant arteries were investigated. Results: Of the hemoptysis-related arteries (n=372) depicted and embolized in the studies, 51.9% was normally-originated bronchial arteries (n=193), 6.7% was ectopic bronchial arteries (n=25), 41.4% was NBSA (n=154). Both anomalous and NBSA arising from subclavicular-axillary area (n=80) were accounted for 21.5% (80/372) of all aberrant arteries, and 44.7% (80/179) of all anomalous and NBSA (n=25 + 154 = 179). Of those arising from subclavicular-axillary arteries, 56.3% (45/80) were found to be originated from the internal thoracic artery (n=45), 98.2% (112/114) of responsible internal thoracic arteries and their distal branches were well depicted by subclavicular angiography with brachial-axillary artery externally and temporally occluded. Conclusion: Subclavicular-axillary artery is a very important vessel where EBA and NBSA originate. Subclavicular angiography with brachial-axillary artery externally and temporally occluded could help to determine the abnormal arteries in the region quickly. The method should be taken as a routine procedure for interventional treatment of hemoptysis. (authors)