All patients signed an informed consent form before the DSA procedure. The femoral artery or radial artery was punctured by Seldinger technique. All relevant systematic arteries (e.g., intercostal artery, subclavian artery, internal thoracic artery) underwent selective arteriography with 5-F curved catheters (Cobra; Cordis) or a left gastric artery catheter (Cook). A microcatheter (2.9-Fr swan-neck microcatheter; Merit Maestro; or 2.7-Fr Progreat; Terumo) was used for superselection of BA or NBSA, noting the spinal arteries’ origin from the BA or intercostal arteries.
The arteries were embolized if any of the following findings were viewed on DSA: (I) contrast agent overflow; (II) parenchymal staining; (III) thickening and tortuous artery; (IV) disorder and roughness of terminal artery; and (V) bronchial-pulmonary artery shunts. Interventional embolization were performed with Embosphere particles (300–500, 500–700, or 700–900 µm in diameter; Biosphere Medical) with or without gelatin sponge granules or strips. Coils or medical glue were used if obvious bronchial-pulmonary artery shunts were present. The injection of embolization materials was terminated when the contrast medium did not clear within three cardiac cycles.
The arteries were embolized if any of the following findings were viewed on DSA: (I) contrast agent overflow; (II) parenchymal staining; (III) thickening and tortuous artery; (IV) disorder and roughness of terminal artery; and (V) bronchial-pulmonary artery shunts. Interventional embolization were performed with Embosphere particles (300–500, 500–700, or 700–900 µm in diameter; Biosphere Medical) with or without gelatin sponge granules or strips. Coils or medical glue were used if obvious bronchial-pulmonary artery shunts were present. The injection of embolization materials was terminated when the contrast medium did not clear within three cardiac cycles.