Clinical Diagnosis
24 year old with congestive heart failure prior LVAD placement and now presenting with recurrent significant hemoptysis and unknown hypervascular mass in the right lower lobe.

Anatomy
Right intercostal angiogram with a 5fr Mickelson revealed a hypervascular mass and filling of the artery of Adamkiewicz which was at high risk for non-targeted delivery.

Vessel Size
3 mm

Treatment Plan
A Surefire 5 Fr Axis Specialty catheter was used to access the right intercostal artery. The Surefire Infusion System ST was advanced into the right intercostal artery, past the artery of Adamkiewicz. The Surefire expandable tip was deployed to minimize possible reflux into the spinal artery. Bland embolization was performed with 300-500 μm Embosphere® Microspheres, and 100% of the planned dose was delivered.

Outcome
The patient’s lower extremity function was assessed throughout the procedure to monitor non-target delivery into the spinal artery, and there was no change in function observed. In post procedure angiography, flow to the hypervascular mass was eliminated while maintaining flow in the anterior radicular artery. The Surefire Infusion System ST enabled bronchial arterial embolization while protecting the artery of Adamkiewicz without any sequelae.