Martine Remy-Jardin MD, PhD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: To evaluate the degree of development of a bronchial collateral supply and the risk of pulmonary infarction according to the site of pulmonary artery obstruction in an experimental model with an anastomosed dual circulation similar to that of human lungs. Methods and Materials: 22 large white Landrace pigs, 7 to 8 weeks of age and 18 to 20 kg of average body weight at the time of the initial procedure underwent the following in vivo angiographic and postmortem procedures: (a) proximal (n=11; Group 1) or distal (n=11; Group 2) occlusion of the left diaphragmatic lobar pulmonary artery using 8-mm coils; (b) 6 weeks after the occlusion procedure, selective bronchial angiography (n=22) and bronchial artery embolization (Group 1: n=11; Group 2: n=2) ipsilateral to the site of pulmonary artery occlusion; (c) 1 week after bronchial angiography, a post-mortem aortography (n=22), aimed at analyzing the development of bronchial circulation by comparison with the controlateral side, and a pathologic study of the vaso-occluded lung (n=22). Results: Dramatic development of the left bronchial arteries down to the peripheral bed was demonstrated beyond the level of coil deposition. Considering the right-sided bronchial arteries as an anatomic standard of reference, the diameter of the left bronchial arteries was : (a) 6 to 10 times larger than that of controlateral arteries in Group 1; (b) 4 times larger than that of controlateral arteries in Group 2. The increase in number and enlargement of the diameter of bronchial artery to pulmonary artery anastomoses were more pronounced after proximal occlusion of the left diaphragmatic lobar pulmonary artery. During the autopsy, no left-sided parenchymal or pleural abnormalities were identified in both groups of animals with microscopic confirmation of the absence of pulmonary infarction. Conclusion: (1) The degree of development of a bronchial collateral supply depends on the site of pulmonary artery obstruction; (2)The absence of pulmonary infarction was a constant finding whatever the level of pulmonary artery occlusion.      

Remy-Jardin MD, PhD, M, Experimental Pulmonary Embolism in Pigs: Evaluation of the Consequences of a Proximal vs Distal Pulmonary Artery Obstruction on the Development of Bronchial Collateral Supply and Risk of Pulmonary Infarction.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3104505.html