[Blood supply of pulmonary metastases and its clinical significance].
OBJECTIVE
Interventional treatment has been widely applied to primary lung carcinoma, but seldom applied to pulmonary metastases because the blood supply of pulmonary metastases has rarely been investigated, and the present understanding is controversial. This study was to explore the correlation of the clinical value of bronchial arterial chemotherapeutic infusion (BAI) combined bronchial arterial embolization (BAE) to the blood supply of pulmonary metastases.


METHODS
Bronchial artery angiography was performed on 33 patients with pulmonary metastases to assess the blood supply and the distribution of pulmonary metastases. BAI was performed on hypovascular nodules, and BAE was performed on hypervascular nodules.


RESULTS
Of the 89 metastatic nodules in the lungs of 33 patients, 63 (70.8%) were located in the mid-medial zone, and 26 (29.3%) in the lateral region of the lung; 56 had abundant blood supply, and 33 had poor blood supply. The blood supply of pulmonary metastases was correlated to the location of metastatic nodules. Most nodules in the mid-medial region had abundant blood supply, while most nodules in the lateral region had poor or had no blood supply (P<0.01). The blood supply of bronchial artery had no correlation to the volume of metastatic nodule (P>0.05). The curative efficacy of BAI and BAE was correlated to the blood supply of bronchial artery. The response rate was significantly higher in the hypervascular nodules treated with BAE than in the hypovascular nodules treated with BAI (71.4% vs. 42.4%, P<0.01). Most pulmonary metastases of hepatic cancer were hypervascular and the lipiodol deposited well in the nodules; during the follow-up, the nodules shrunk significantly and kept stable.


CONCLUSIONS
Bronchial artery is the major feeding artery of pulmonary metastases. BAI and BAE are effective in treating pulmonary metastases with abundant blood supply.
Jiang
Guo-Min
GM
Department of Interventional Radiology, The Affiliated Second Peopleos Hospital of Changzhou City, Nanjing Medical University, Changzhou, Jiangsu, 213003, P. R. China. jgm916@163.com
Zhao
Jin-Wei
JW
Chen
Ya-Xian
YX
Tian
Feng
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001981:Bronchial Arteries / Q000000981:diagnostic imaging*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007261:Infusions, Intra-Arterial; D007459:Iodized Oil / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000473:pathology; D008175:Lung Neoplasms / Q000098:blood supply* / Q000556:secondary / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000473:pathology; D055815:Young Adult
D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; C527042:hydroxycamptothecinum; D015251:Epirubicin; D007459:Iodized Oil; D005472:Fluorouracil; D002166:Camptothecin