J Korean Soc Radiol.  2015 Sep;73(3):195-198. 10.3348/jksr.2015.73.3.195.

Left Bronchial Artery Arising from a Replaced Left Hepatic Artery in a Patient with Massive Hemoptysis

  • 1Department of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea. l96j80m@hanmail.net


A 70-year-old man with a 3-year history of bronchiectasis presented with massive hemoptysis that had lasted for 3 days. In our attempt to perform bronchial artery embolization, upper abdominal angiography was required to locate the left bronchial artery, which in this case was of anomalous origin, arising from a replaced left hepatic artery, which arose from the left gastric artery-a very unusual anatomical variant. We performed embolization with polyvinyl alcohol particles, and the patient's symptoms resolved completely, with no additional complications after conservative treatment.

MeSH Terms

Bronchial Arteries*
Hepatic Artery*
Polyvinyl Alcohol
Polyvinyl Alcohol


  • Fig. 1 A 70-year-old man with massive hemoptysis. A. A coronal CT reconstruction image shows bronchiectasis in both lower lungs. B. A coronal reformatted image shows a certain dilated and tortuous artery (arrowheads), originating from the replaced left hepatic artery (arrows), that traveled upward along the descending thoracic aorta. C. Angiography of the descending thoracic aorta shows a hypertrophied and tortuous artery (arrows) traveling upward along the thoracic aorta toward the left hilum, suspected to arise from a branch of the celiac trunk. D. Selective angiography of the celiac trunk reveals that the abnormal artery traveling along the left main bronchus originates from the replaced left hepatic artery (arrowheads). An angiogram of this aberrant left bronchial artery (arrows) shows abnormal parenchymal staining at the basal segment of the left lower lobe.


1. Chun JY, Morgan R, Belli AM. Radiological management of hemoptysis: a comprehensive review of diagnostic imaging and bronchial arterial embolization. Cardiovasc Intervent Radiol. 2010; 33:240–250.
2. Yoon W, Kim JK, Kim YH, Chung TW, Kang HK. Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review. Radiographics. 2002; 22:1395–1409.
3. Bruzzi JF, Rémy-Jardin M, Delhaye D, Teisseire A, Khalil C, Rémy J. Multi-detector row CT of hemoptysis. Radiographics. 2006; 26:3–22.
4. Ponnuswamy I, Sankaravadivelu ST, Maduraimuthu P, Natarajan K, Sathyanathan BP, Sadras S. 64-detector row CT evaluation of bronchial and non-bronchial systemic arteries in life-threatening haemoptysis. Br J Radiol. 2012; 85:e666–e672.
5. Remy-Jardin M, Bouaziz N, Dumont P, Brillet PY, Bruzzi J, Remy J. Bronchial and nonbronchial systemic arteries at multi-detector row CT angiography: comparison with conventional angiography. Radiology. 2004; 233:741–749.
6. Remy J, Voisin C, Ribet M, Dupuis C, Beguery P, Tonnel AB, et al. [Treatment, by embolization, of severe or repeated hemoptysis associated with systemic hypervascularization]. Nouv Presse Med. 1973; 2:2060.
7. Cauldwell EW, Siekert RG, Lininger RE, Anson BJ. The bronchial arteries; an anatomic study of 150 human cadavers. Surg Gynecol Obstet. 1948; 86:395–412.
8. Jiang S, Sun XW, Yu D, Jie B. Aberrant left inferior bronchial artery originating from the left gastric artery in a patient with acute massive hemoptysis. Cardiovasc Intervent Radiol. 2013; 36:1420–1423.
9. Battal B, Akgun V, Karaman B, Bozlar U, Tasar M. Normal anatomical features and variations of bronchial arteries: an analysis with 64-detector-row computed tomographic angiography. J Comput Assist Tomogr. 2011; 35:253–259.
10. In HS, Bae JI, Park AW, Kim YW, Choi SJ. Bronchial artery arising from the left gastric artery in a patient with massive haemoptysis. Br J Radiol. 2006; 79:e171–e173.
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