Bronchial artery

In human anatomy, the bronchial arteries supply the lungs with oxygenated blood, and nutrition. Although there is much variation, there are usually two bronchial arteries that run to the left lung, and one to the right lung, and are a vital part of the respiratory system.

Bronchial artery
Bronchial artery labeled at center right
Details
SourceThoracic aorta
VeinBronchial veins
SuppliesLungs
Identifiers
LatinArteriae bronchiales,
rami bronchiales partis thoracicae aortae
MeSHD001981
TA98A12.2.11.002
TA24579
FMA68109 71536, 68109
Anatomical terminology

Structure

There are typically two left and one right bronchial arteries.[1]

The left bronchial arteries (superior and inferior) usually arise directly from the thoracic aorta.[2]

The single right bronchial artery usually arises from one of the following:

Function

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.

Comparison with pulmonary arteries

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:

arteryfunctioncirculationdiameter
pulmonary arteriessupplies deoxygenated blood pumped from the right ventriclepulmonary circulationrelatively large
bronchial arteriessupplies oxygenated blood pumped from the left ventriclesystemic circulationrelatively small

Clinical significance

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.[1]

The bronchial arteries are typically enlarged and tortuous in chronic pulmonary thromboembolic hypertension.[3]

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.[4]

Aneurysms of the bronchial artery may mimic aortic aneurysms.[5] Bronchial artery embolisation (BAE) is catheter insertion into a bronchial artery to treat hemoptysis (coughing blood).[6][7]. 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).[8]

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.[9] The bronchial arteries can maintain a supply of oxygenated blood to lung tissue.

See also

References
  1. Marini TJ, He K, Hobbs SK, Kaproth-Joslin K (December 2018). "Pictorial review of the pulmonary vasculature: from arteries to veins". Insights into Imaging. 9 (6): 971–987. doi:10.1007/s13244-018-0659-5. PMC 6269336. PMID 30382495.
  2. Leslie KO, Wick MR (January 2018). "Lung anatomy.". In Leslie KO, Wick MR (eds.). Practical Pulmonary Pathology: A Diagnostic Approach (Third ed.). Elsevier. pp. 1–14. doi:10.1016/b978-0-323-44284-8.00001-6. ISBN 978-0-323-44284-8.
  3. Kauczor HU, Schwickert HC, Mayer E, Schweden F, Schild HH, Thelen M (1994). "Spiral CT of bronchial arteries in chronic thromboembolism". Journal of Computer Assisted Tomography. 18 (6): 855–861. doi:10.1097/00004728-199411000-00002. PMID 7962789. S2CID 25591310.
  4. Nowak K, Kamler M, Bock M, Motsch J, Hagl S, Jakob H, Gebhard MM (January 2002). "Bronchial Artery Revascularization affects Graft Recovery after Lung Transplantation". American Journal of Respiratory and Critical Care Medicine. 165 (2): 216–20. doi:10.1164/ajrccm.165.2.2012101. PMID 11790658.
  5. Vernhet H, Bousquet C, Jean B, Lesnik A, Durand G, Giron J, Senac JP (1999). "Bronchial aneurysms mimicking aortic aneurysms: endovascular treatment in two patients". CardioVascular and Interventional Radiology. 22 (3): 254–257. doi:10.1007/s002709900378. PMID 10382061. S2CID 23659854.
  6. James WE (2019-01-01). "Chapter 23 - Nonpharmacological Therapy for Pulmonary Sarcoidosis". In Baughman RP, Valeyre D (eds.). Sarcoidosis. Philadelphia: Elsevier. pp. 277–284. doi:10.1016/b978-0-323-54429-0.00023-9. ISBN 978-0-323-54429-0. S2CID 239263865.
  7. Garwood S, Strange C, Sahn SA (2008-01-01). "Chapter 47 - Massive Hemoptysis". In Parrillo JE, Dellinger RP (eds.). Critical Care Medicine (Third ed.). Philadelphia: Mosby. pp. 929–948. doi:10.1016/b978-032304841-5.50049-2. ISBN 978-0-323-04841-5.
  8. Boas FE, Kemeny NE, Sofocleous CT, Yeh R, Thompson VR, Hsu M, Moskowitz CS, Ziv E, Yarmohammadi H, Bendet A, Solomon SB (2021). "Bronchial or Pulmonary Artery Chemoembolization for Unresectable and Unablatable Lung Metastases: A Phase I Clinical Trial". Radiology. 301 (2): 474–84. doi:10.1148/radiol.2021210213. PMC 8574062. PMID 34463550.
  9. Fishman AP (September 1961). "The clinical significance of the pulmonary collateral circulation". Circulation. American Heart Association. 24 (3): 677–690. doi:10.1161/01.CIR.24.3.677. eISSN 1524-4539. PMID 13700013.
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