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Bronchial arteries are the systemic arteries that supply oxygenated blood to the bronchi, visceral pleura, lymph nodes, esophagus, and supporting structures of the lungs. Unlike the pulmonary arteries (which carry deoxygenated blood), bronchial arteries arise from the aorta or its branches and are part of the high-pressure systemic circulation.

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Anatomy

Origin

Typical Sites of Origin	Comments
Thoracic aorta (T5–T6)	Most common origin
Intercostal arteries	Especially the 3rd–6th posterior intercostal
Subclavian, internal mammary, or abdominal aorta	Considered aberrant origins

Usually 1 right and 2 left bronchial arteries, but variable anatomy is common.
Right bronchial artery often arises with an intercostal artery (common trunk).

Course

Enter the lungs via the hilum
Travel along the posterior walls of the bronchi
Anastomose with pulmonary arterial circulation at the respiratory bronchiole level

![Variations of the bronchial arteries. Bronchial arteries may have a great variability in terms of number. The most common patterns are two left and one right bronchial artery (type 1, most common), one artery in each side (type 2), two right and two left bronchial arteries (type 3), and two right and one left bronchial artery (type 4). Usually, the right bronchial artery originates from an intercostal-bronchial trunk (ICBT). RBA, right bronchial artery; LBA, left bronchial artery; ICBT, intercostal-bronchial trunk; ICA, intercostal artery

Almeida, J., Leal, C. & Figueiredo, L. Evaluation of the bronchial arteries: normal findings, hypertrophy and embolization in patients with hemoptysis. Insights Imaging 11, 70 (2020). https://doi.org/10.1186/s13244-020-00877-4 ](attachment:781f9330-57a0-4c94-be35-8d347b96903a:Variations_of_the_bronchial_arteries.webp)

Variations of the bronchial arteries. Bronchial arteries may have a great variability in terms of number. The most common patterns are two left and one right bronchial artery (type 1, most common), one artery in each side (type 2), two right and two left bronchial arteries (type 3), and two right and one left bronchial artery (type 4). Usually, the right bronchial artery originates from an intercostal-bronchial trunk (ICBT). RBA, right bronchial artery; LBA, left bronchial artery; ICBT, intercostal-bronchial trunk; ICA, intercostal artery

Physiological Role

Normally <1 mm in diameter; may become tortuous and enlarged (>2 mm) in disease states.

Function	Structures Supplied
Nutritional supply	Bronchi, large airways, visceral pleura
Collateral circulation	In chronic pulmonary artery obstruction (e.g., CTEPH)
Involvement in disease	Hyperplasia in infections, tumors, or inflammation

Clinical Significance

1. Hemoptysis Source

Bronchial arteries are responsible for ~90% of massive hemoptysis cases