Bronchial Artery Embolization: “ When one artery closes the other one opens”

Monday, March 31, 2025

5:00 PM – 5:05 PM CT

Location: Music City Center, 201 AB

Abstract Presenter(s)

Sandra Gad

Medical Student
SGU, United States

Author/Co-author(s)

Michael Mohnasky, MS (he/him/his)

Medical Student
UNC School of Medicine, United States
BH

Bryan Harris, MD

Resident
UNC Chapel Hill, United States
Alex Villalobos, MD

Assistant Professor
University of North Carolina - Chapel Hill, United States
LD

Lourens Du Pisanie, MD

Resident
UNC Chapel Hill, United States
Andrew Caddell

Medical Student
UNC School of Medicine, United States
HS

Haneyeh Shahbazian, MD

Resident
UNC, United States
HW

Hui Wang, PhD

Research
UNC, United States
AA

Ali Afrasiabi, MD

Postdoctoral Researcher
University of North Carolina - Chapel Hill - Department of Interventional Radiology, United States
Nima Kokabi, MD

Associate Professor of Radiology
University of North Carolina - Chapel Hill, United States

Learning Objectives:

1. To illustrate and understand technical challenges and tips for managing bronchial artery embolization (BAE)

2. To explore alternative access sites for BAE with femoral arteries are not accessible

Background:

Bronchial artery embolization (BAE) is a critical, often life-saving procedure for patients with massive hemoptysis. Traditionally, femoral artery access has been used based on catheter availabilities and prior experience. Radial access has not been generally explored as an alternative route to catheterize bronchial arteries due to several reasons including lack of specific catheters and challenging anatomy. For abdominal and pelvic angiography, left radial access is often preferred due to minimizing catheters and wires traversing across aortic arch vasculature and thereby theoretically reducing stroke risk. Right radial access, although less commonly used, can offer a viable alternative, particularly for BAE, because of the ability to form the most commonly used radial catheters across the aortic arch to successfully cannulate the bronchial arteries, which arise as early branches of the descending thoracic aorta.

Clinical Findings/Procedure Details:

This study examines right-sided BAE in cases where femoral access was feasible. It details the techniques and catheter choices used to navigate the right radial approach successfully, as well as instances where right radial access attempts failed. These cases provide valuable insight into the challenges and limitations of using right radial access for BAE, highlighting specific examples to guide interventional radiologists in future procedures.

Conclusion and/or Teaching Points:

Right radial access, while not the first choice for BAE, is a valuable option when femoral access is not feasible

Radiologists should be familiar with techniques and limitations for right trans-radial access to be used for BAE