J Korean Soc Radiol.  2015 Sep;73(3):195-198. 10.3348/jksr.2015.73.3.195.

Left Bronchial Artery Arising from a Replaced Left Hepatic Artery in a Patient with Massive Hemoptysis

• Khil EK
• Lee JM

• KMID: 2043612
• DOI: http://doi.org/10.3348/jksr.2015.73.3.195

Abstract

A 70-year-old man with a 3-year history of bronchiectasis presented with massive hemoptysis that had lasted for 3 days. In our attempt to perform bronchial artery embolization, upper abdominal angiography was required to locate the left bronchial artery, which in this case was of anomalous origin, arising from a replaced left hepatic artery, which arose from the left gastric artery-a very unusual anatomical variant. We performed embolization with polyvinyl alcohol particles, and the patient's symptoms resolved completely, with no additional complications after conservative treatment.

MeSH Terms

Aged
Angiography
Bronchial Arteries*
Bronchiectasis
Hemoptysis*
Hepatic Artery*
Humans
Polyvinyl Alcohol
Polyvinyl Alcohol

Figure

• 

  Fig. 1 A 70-year-old man with massive hemoptysis. A. A coronal CT reconstruction image shows bronchiectasis in both lower lungs. B. A coronal reformatted image shows a certain dilated and tortuous artery (arrowheads), originating from the replaced left hepatic artery (arrows), that traveled upward along the descending thoracic aorta. C. Angiography of the descending thoracic aorta shows a hypertrophied and tortuous artery (arrows) traveling upward along the thoracic aorta toward the left hilum, suspected to arise from a branch of the celiac trunk. D. Selective angiography of the celiac trunk reveals that the abnormal artery traveling along the left main bronchus originates from the replaced left hepatic artery (arrowheads). An angiogram of this aberrant left bronchial artery (arrows) shows abnormal parenchymal staining at the basal segment of the left lower lobe.

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