[Superselective bronchial arterial catheterization via a sheath catheter (SS-BAC)]

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.