The bronchial arteries: anatomic study and application to lung transplantation

The bronchial arterial system (BAS) and its territory was studied in dissections of 40 fresh adult cadavers. The arterial distribution was assessed by catheterisation of the ostia and injection of contrast medium. The number of bronchial aa. varied from 2 to 4. The origin of the arteries was between the upper border of T5 and the lower border of T6 in 90% of cases. The intercostobronchial trunk was the virtually exclusively component of the right bronchial arterial system, present in 97.5% of cases. It was associated with an accessory right bronchial a. in 7.5% of cases, which was merely supplementary. A common arterial trunk for both bronchial systems was present in 50% of cases. The left BAS was characterised by the presence of a direct left bronchial a. (LBA) in 76% of cases, and by the combination of two LBAs in 20%, one of which was usually dominant. However, major anatomic networks between the different vessels found allowed reimplantation of the LBA alone in the former situation, and in the latter it was possible to rely on the dominant LBA alone when reimplantation of the different ostia was impossible. The proximity of the different ostia and the interostial interval, which was less than 1.5 cm on average, permitted multiple revascularisations by the same vascular supply.