Since patients suffering from bronchogenic carcinoma are often elderly and debilitated, diagnostic thoracotomy for unresectable lung cancer is accompanied by an operative mortality up to 15%.1 Thus, it is clearly important to minimize the number of "open and close" operations, even if one disregards the emotional and financial trauma resulting from an unrewarding thoracotomy. Towards the goal of improving the selection of lung cancer patients to whom thoracotomy is recommended, preoperative angiography has been utilized. Our purpose has been to determine whether or not this is a fruitful and warranted approach, and we have therefore adhered to standard operative indications and contraindications, seeking not to allow angiographic findings influence our decision as to whether or not to operate.
Lung cancers become unresectable when they involve essential major vessels or the heart, or when the mediastinum is massively invaded by tumor. Although others have utilized angiography to evaluate the extent
Benfield JR, Bonney H, Crummy AB, Cleveland RJ. Azygograms and Pulmonary Arteriograms in Bronchogenic Carcinoma. Arch Surg. 1969;99(3):406-409. doi:10.1001/archsurg.1969.01340150114025