Embolization for Hemoptysis: A Six -Year Review

Abstract

Embolization is effective for treatment of moderate to massive hemoptysis. The majority of our cases were due to tuberculosis. Approximately one third had nonbronchial systemic artery contributions, indicating that a concerted search for these is mandatory.

Outcome and complications of bronchial artery embolisation for life-threatening haemoptysis

“…This result is in accordance with previous reports in which BAE resulted in an immediate arrest of bleeding in 73-98% of patients [1,5,6,16,17]. Rebleeding occurred within 24 h in 1 patient, and this was attributed to an incomplete initial procedure.…”

“…Mortality risk in massive haemoptysis is reported to be between 30 and 40% when treated surgically during the acute episode [2,3], and when untreated, this mortality rate increases to [50% [4]. In life-threatening haemoptysis, bleeding originates in most cases from bronchial arteries or from nonbronchial systemic collateral vessels [1,5,6]. Angiographic detection and selective endovascular embolisation of the bleeding source is reported to be an effective therapy in patients considered surgically inoperable because of either acute hypoxaemia or limited pulmonary reserve [7,8].…”

“…Despite widespread practice of bronchial artery embolisation (BAE) for over three decades, relatively little data outline the short-term (first 30 days) and long-term (1-2 years) outcomes of this therapeutic modality. Success rates for BAE as first line therapy in the management of massive haemoptysis have been reported to range between 79 and 84% [5,6].…”

Risk factors associated with fatal pulmonary hemorrhage in locally advanced non-small cell lung cancer treated with chemoradiotherapy

“…For the management of massive and recurrent hemoptysis, bronchial artery embolization (BAE) is also a demonstrated treatment option [24-31]; however, the bleeding recurrence rate among patients with BAE-treated lung cancer can reach 50% [32]. Surgical intervention, in contrast, is curative [33] and an established treatment for PH.…”

Cavitated Conglomerate Mass in Silicosis Indicating Associated Tuberculosis

“…Recurrent bleeding is common in patients with chronic tuberculosis. In one study of 103 patients who underwent bronchial arterial embolization, 16 (15.5%) required repeat embolization, and all had hemoptysis due to chronic tuberculosis [23]. …”