Bronchial artery

There are typically two left and one right bronchial arteries.{{cite journal | vauthors = Marini TJ, He K, Hobbs SK, Kaproth-Joslin K | title = Pictorial review of the pulmonary vasculature: from arteries to veins | journal = Insights into Imaging | volume = 9 | issue = 6 | pages = 971–987 | date = December 2018 | pmid = 30382495 | pmc = 6269336 | doi = 10.1007/s13244-018-0659-5 }}

The left bronchial arteries (superior and inferior) usually arise directly from the thoracic aorta.{{cite book | vauthors = Leslie KO, Wick MR | chapter = Lung anatomy. | title = Practical Pulmonary Pathology: A Diagnostic Approach | edition = Third | date = January 2018 | pages = 1–14 | veditors = Leslie KO, Wick MR |publisher=Elsevier |doi=10.1016/b978-0-323-44284-8.00001-6 |isbn=978-0-323-44284-8 }}

The single right bronchial artery may arise from one of the following:

• 1) in typical anatomy, the thoracic aorta at a common trunk with the right 3rd posterior intercostal artery (known as the intercostobronchial trunk).
• 2) the superior bronchial artery on the left side.
• 3) any number of the right intercostal arteries mostly the third right posterior.

The bronchial arteries supply blood to the bronchi and connective tissue of the lungs. They travel with and branch with the bronchi, ending about at the level of the respiratory bronchioles. They anastomose with the branches of the pulmonary arteries, and together, they supply the visceral pleura of the lung in the process.

Note that much of the oxygenated blood supplied by the bronchial arteries is returned via the pulmonary veins rather than the bronchial veins. As a consequence, blood returning to the left heart is slightly less oxygenated than blood found at the level of the pulmonary capillary beds.

Each bronchial artery also has a branch that supplies the esophagus.

It is easy to confuse the bronchial arteries with the pulmonary arteries, because they both supply the lungs with blood, but there are important differences:

Bronchial artery is considered dilated when its diameter is more than 2 mm. Several causes of bronchial artery dilatations are: congenital heart or lung diseases, obstructions of pulmonary artery, and lung inflammation.

The bronchial arteries are typically enlarged and {{Linktext|tortuous}} in chronic pulmonary thromboembolic hypertension.{{cite journal | vauthors = Kauczor HU, Schwickert HC, Mayer E, Schweden F, Schild HH, Thelen M | title = Spiral CT of bronchial arteries in chronic thromboembolism | journal = Journal of Computer Assisted Tomography | volume = 18 | issue = 6 | pages = 855–861 | year = 1994 | pmid = 7962789 | doi = 10.1097/00004728-199411000-00002 | s2cid = 25591310 }}

With modern surgical techniques, bronchial anastomoses heal well without bronchial artery reconnection. Largely for this reason, bronchial artery circulation is usually sacrificed during lung transplants, instead relying on the persistence of a microcirculation (presumably arising from the deoxygenated pulmonary circulation) to provide perfusion to the airways.{{cite journal | vauthors = Nowak K, Kamler M, Bock M, Motsch J, Hagl S, Jakob H, Gebhard MM | title = Bronchial Artery Revascularization affects Graft Recovery after Lung Transplantation | journal = American Journal of Respiratory and Critical Care Medicine | volume = 165 | issue = 2 | pages = 216–20 | date = January 2002 | pmid = 11790658 | doi = 10.1164/ajrccm.165.2.2012101 }}

Aneurysms of the bronchial artery may mimic aortic aneurysms.{{cite journal | vauthors = Vernhet H, Bousquet C, Jean B, Lesnik A, Durand G, Giron J, Senac JP | title = Bronchial aneurysms mimicking aortic aneurysms: endovascular treatment in two patients | journal = CardioVascular and Interventional Radiology | volume = 22 | issue = 3 | pages = 254–257 | year = 1999 | pmid = 10382061 | doi = 10.1007/s002709900378 | s2cid = 23659854 }} Bronchial artery embolisation (BAE) is catheter insertion into a bronchial artery to treat hemoptysis (coughing blood).{{cite book | vauthors = James WE | chapter = Chapter 23 - Nonpharmacological Therapy for Pulmonary Sarcoidosis|date=2019-01-01 | title = Sarcoidosis|pages=277–284| veditors = Baughman RP, Valeyre D |place=Philadelphia |publisher=Elsevier |doi=10.1016/b978-0-323-54429-0.00023-9 |isbn=978-0-323-54429-0 | s2cid = 239263865}}{{cite book | vauthors = Garwood S, Strange C, Sahn SA | chapter = Chapter 47 - Massive Hemoptysis |date=2008-01-01 |title = Critical Care Medicine | edition = Third |pages=929–948| veditors = Parrillo JE, Dellinger RP |place=Philadelphia|publisher=Mosby|language=en|doi=10.1016/b978-032304841-5.50049-2|isbn=978-0-323-04841-5 }} Most lung tumors are supplied by the bronchial artery, and they can be treated by chemoembolization (injecting chemotherapy and particles directly into the tumor-feeding artery).{{cite journal | vauthors = Boas FE, Kemeny NE, Sofocleous CT, Yeh R, Thompson VR, Hsu M, Moskowitz CS, Ziv E, Yarmohammadi H, Bendet A, Solomon SB | title = Bronchial or Pulmonary Artery Chemoembolization for Unresectable and Unablatable Lung Metastases: A Phase I Clinical Trial | journal = Radiology | volume = 301 | issue = 2 | pages = 474–84 | date = 2021 | doi = 10.1148/radiol.2021210213 | pmid = 34463550 | pmc = 8574062 }}

The bronchial arteries and their supply of nutrients to the lungs are also attributed to the observation that an occluded (either ligated or by an embolus) pulmonal artery very rarely results in lung infarction.{{cite journal | vauthors = Fishman AP | title = The clinical significance of the pulmonary collateral circulation | journal = Circulation | volume = 24 | issue = 3 | pages = 677–690 | date = September 1961 | pmid = 13700013 | doi = 10.1161/01.CIR.24.3.677 | publisher = American Heart Association | doi-access = free | eissn = 1524-4539 }} The bronchial arteries can maintain a supply of oxygenated blood to lung tissue.

• Bronchial veins
• Pulmonary thromboendarterectomy

{{Reflist}}

• {{SUNYAnatomyFigs|21|06|06}} - "Branches of the ascending aorta, arch of the aorta, and the descending aorta."
• {{BUHistology|13903loa}}
• [https://web.archive.org/web/20060929032122/http://anatquest.nlm.nih.gov/aq/ImageXml?xml=DSR100006257-xsl.xml Bronchial arteries] - anatquest.nlm.nih.gov.

{{Arteries of chest}}

{{Authority control}}

Category:Arteries of the thorax