Arteriography

Selective arteriography can be used to assess the bronchial or pulmonary arterial circulation. Arteriography has a distinct advantage when the source of bleeding is peripheral to the bronchoscope's area of visualization and when bronchoscopy fails to localize the bleeding. Arteriographic findings suggestive of a bleeding vessel include parenchymal hypervascularity, vascular hypertrophy and/or tortuosity, capillary stasis, bronchopulmonary shunting, aneurysm formation, and thrombosis of vessels (Rabkin et.aL 1987). Rarely, acute extravasation of contrast medium from the bronchial vasculature is seen when there is active bleeding during the procedure. Embolization of the bleeding vessel can often be performed and will be discussed below.

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