Bronchial Artery Embolization as a Therapeutic Strategy for Management of Massive Hemoptysis

Abstract

Background: Massive hemoptysis is an emergent and lifethreatening condition with a high mortality rate. Bronchoscopy and MDCT scanning show significant contributing roles in delineating the etiology and the source of hemoptysis prior to bronchial artery arteriography. Aim of the work:To validate the role of the trans-catheter bronchial artery embolization in management of massive hemoptysis.Patients and Methods: Our study is a prospective cohort study that was held during the period between April 2017 and April 2019. The study included 20 patients who presented with massive hemoptysis refractory to supportive treatment measures with nonidentifiable source of bleeding on fiber-optic bronchoscope. Patients were referred from chest department to angio unit.Results: Our findings are in accordance with the current literature supporting bronchial artery embolization as a safe and long-term non-invasive effective method of treatment for massive hemoptysis with a high initial rate of success. BAE may help to avoid surgery in patients who are not good surgical candidates. If hemoptysis recur in these patients, embolization can be safely performed with good response rate. If surgery is indicated, BAE can stabilize the patient prior to surgery. Conclusion:Advancements in angiographic equipment and technique continue to improve success rates, and with careful technique, it can be performed safely and with minimal risk. Embolization distal to the spinal artery may significantly decrease the number of complications and may allow a more thorough embolization.

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“…Although bronchoscopy and computed tomography (CT) is crucial for determining the source and location of bleeding, the angiography approach is very crucial since it is both diagnostic and therapeutic (3) . Cavitary lung lesions, which can include lung abscesses, aspergillosis, and post-TB sequelae, accounted for 25% of instances of hemoptysis (4) .…”