Nagai S, Iwasaki N, Koshiishi M, Chimoto M, Seki Y, Horie S
Nihon Kyobu Geka Gakkai Zasshi. 1989 Apr;37(4):702-9.
Bronchial artery infusion therapy including embolization of the artery has been widely used in the treatment of lung cancer and also for the treatment of hemoptysis due to various lung diseases. However, some serious complications such as spinal cord lesion, tracheobronchial fistula formation and so on have been documented in the literature and these complications are attributed to anatomical characteristics of the bronchial artery having a common trunk with feeding arteries to the spinal cord, esophagus and trachea. To prevent these hazardous events we attempted to infuse and embolize the proper bronchial artery with high selectivity by using catheter-in-catheter technique. A Cook green catheter, 7.2 Fr. size, was wedged in the intercostobronchial trunk artery by a Seldinger technique and then a small catheter, 3.0 Fr. size, was passes through the former catheter to the proper bronchial artery beyond the orifices of other feeding arteries. In 26 out of 30 patients who underwent this procedure we successfully performed this superselective bronchial artery catheterization and the 26 patients consisted of 15 patients with lung cancer and one with metastatic lung tumor who were treated with bronchial artery infusion therapy and ten with various lung diseases who were treated with bronchial artery embolization because of hemoptysis. Bronchial artery infusion therapy including embolization has gained higher safety and effectiveness by means of this superselective catheterization.
包括动脉栓塞术在内的支气管动脉灌注疗法已广泛应用于肺癌治疗，也用于治疗各种肺部疾病引起的咯血。然而，文献中已记载了一些严重并发症，如脊髓损伤、气管支气管瘘形成等，这些并发症归因于支气管动脉与脊髓、食管和气管的供血动脉有共同主干的解剖特征。为预防这些危险事件，我们尝试采用导管套导管技术高选择性地灌注和栓塞合适的支气管动脉。一根7.2 Fr. 尺寸的库克绿色导管通过Seldinger技术楔入肋间支气管干动脉，然后一根3.0 Fr. 尺寸的小导管经前一根导管插入，越过其他供血动脉开口到达合适的支气管动脉。在接受该操作的30例患者中，26例成功进行了这种超选择性支气管动脉插管，这26例患者包括15例接受支气管动脉灌注治疗的肺癌患者、1例接受支气管动脉灌注治疗的肺转移瘤患者，以及10例因咯血接受支气管动脉栓塞治疗的各种肺部疾病患者。通过这种超选择性插管，包括栓塞术在内的支气管动脉灌注疗法已获得更高的安全性和有效性。
