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Bronchial artery embolization (BAE) is an effective and widely used treatment in patients with massive, recurrent hemoptysis, particularly when it is related to inflammatory lung diseases such as acute and chronic pulmonary tuberculosis, bronchiectasis, and aspergillomas (1). Anomalous bronchial arteries occur frequently at ectopic sites other than the upper descending thoracic aorta. There are various aberrant bronchial arteries, and precise anatomical knowledge of these variations is necessary prior to BAE. For an accurate evaluation of massive hemoptysis, computed tomography (CT) is usually employed and is helpful in localizing the site of bleeding and in detecting the bronchial arteries, including those with anatomical variations. Moreover, CT is valuable for determining the underlying disorder inducing the hemoptysis (2, 3). Recently, multidetector computed tomography with angiography is being used more often. The anatomy of the bronchial artery is often beautifully demonstrated with these combined techniques, which can be very helpful prior to angiography (4, 5). We encountered an extremely rare case of aberrant left bronchial artery arising from a replaced left hepatic artery in a 70-year-old man with massive hemoptysis.

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