Hashimoto M, Heianna J, Okane K, Izumi J, Watarai J
Department of Radiology, Akita University School of Medicine, Akita City, Japan.
Acta Radiol. 1999 Mar;40(2):187-90. doi: 10.3109/02841859909177736.
The purpose of this study was to determine the factors influencing development of blood supply from the internal mammary artery and to discuss the value of embolization of the abnormal branches from this vessel using small particles following occlusion of the normal distal branches using microcoils in treating hemoptysis.
Five patients with hemoptysis underwent internal mammary artery embolization with coaxial microcatheter systems. Bronchoscopy, chest radiographs, and CT were performed to determine the site and extent of the basic disease before embolotherapy in all patients.
In all patients, pulmonary lesions had extended from the lung to the adjacent pleural surface at the anterior lung field. Four patients underwent embolization from the proximal portion of the internal mammary artery following distal coil embolization. One patient who underwent only proximal embolization had recurrent bleeding.
The internal mammary artery contributes to the perfusion of lesions responsible for hemoptysis when the basic lesion involves the pulmonary parenchyma adjacent to the anterior pleural surface. Initial distal occlusion of the internal mammary artery may improve the efficacy of embolization of this artery for hemoptysis.
本研究的目的是确定影响胸廓内动脉血供形成的因素，并探讨在使用微线圈闭塞正常远端分支后，用小颗粒栓塞该血管异常分支在治疗咯血中的价值。
5例咯血患者采用同轴微导管系统进行胸廓内动脉栓塞。所有患者在栓塞治疗前均行支气管镜检查、胸部X线片和CT检查，以确定基础疾病的部位和范围。
所有患者的肺部病变均从前胸壁肺野延伸至邻近胸膜表面。4例患者在远端线圈栓塞后从胸廓内动脉近端进行栓塞。1例仅接受近端栓塞的患者出现复发性出血。
当基础病变累及前胸壁胸膜表面附近的肺实质时，胸廓内动脉参与咯血相关病变的灌注。胸廓内动脉初始远端闭塞可能提高该动脉栓塞治疗咯血的疗效。
