Evaluating bronchial drainage pathways in patients with lung disease using digital subtraction angiography.

RATIONALE AND OBJECTIVES: The purpose of the study was to evaluate the venous drainage pathways of the bronchial circulation during bronchial embolotheraphy or infusion therapy. METHODS: The subjects consisted of 21 patients with lung disorders. All of them underwent bronchial arteriography for drug infusion or embolization. Bronchial arteriography was done using both cut-film and digital subtraction methods. RESULTS: The venous drainage pathways of arteriograms could be determined in 15 (71%) patients and classified into the four types: type 1, direct drainage into a pulmonary vein; type 2, drainage into a pulmonary artery with antegrade flow; type 3, drainage into a pulmonary artery with retrograde flow; and type 4, drainage into a bronchial vein. No drainage route could be identified in six (29%) patients. CONCLUSIONS: Digital subtraction angiography can depict the venous drainage pathways in most patients. Drainage occurs into a pulmonary vein in the majority of patients.