Bronchial artery coils

Various embolic agents can be employed for bronchial artery embolization, and include gelatin sponge, microspheres and coils. 

Stainless steel or platinum coils and detachable balloons are rarely used as aprimaryembolicagentinbron-chial artery embolization. Although these can be used to occlude a pathologic bronchial artery efficiently, use of coils predudes repeat embolization, which is often needed as patients are prone to distal collateralization (Fig. 16.21) [43,44]. The primary indication for use of coils is in patients with a bronchial artery aneurysm. Secondly, in cases where a superselective position of a (micro) catheter cannot be reached, coils can be used to protect a normal distal vascular territory against inadvertent embolization [25]. 

One report of cerebral infarction occurring 1 week after coil embolization of a single PAVM has been recently published [39]. Clot migration from the embolized PAVM partially reperfused via a previously embolized feeding pulmonary artery and a bronchial artery was the supposed mechanism accounting for this stroke [39]. 

Winkler K et al. (1990) Effect of intraarterial versus intravenous cisplatin in addition to systemic doxorubicin, high-dose methotrexate, and ifosfamide on histologic tumor response in osteosarcoma (study COSS-86). Cancer 66 1703-1710 Witt C et al. (2000) Value of bronchial artery embolisation with platinum coils in tumorous pulmonary bleeding. Eur J Cancer 36 1949-1954... 

Fig. 23.11a-d). Coil embolization or surgical ligation of bronchial arteries should be avoided because they hinder subsequent catheterization of the proximally occluded vessel. Careful attention should be paid for the identification of spinal arteries arising from the bronchial or intercostal arteries. The localizing value of emergency bronchoscopy or multidetector CT scanning prior to embolization remains to be evaluated. 

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