A young man with pulmonary tuberculosis presents with massive recurrent hemoptysis. For angiographic treatment, which vascular structure should be evaluated first?

Hemoptysis is usually mild in TB, occasionally it can be massive. When massive, it is of bronchial aery or nonpulmonary systemic aery origin. Blood supply to lung parenchyma comes from bronchial aery, which originates from aoa or intercostals aeries and is therefore pa of high pressure systemic circulation. It is the source of bleeding in bronchitis or bronchiectasis or in endobronchial tumors. Severe hemoptysis from bronchial aeries can be treated with angiographic embolization of the bronchial aeries. Ref: Textbook of Pulmonary and Critical Care Medicine By S. K. Jindal, SK Jindal, M.D. Page 540.