Bronchial artery embolization for hemoptysis

Massive hemoptysis is a life-threatening condition. Since treatment from surgery has high mortality, bronchial artery embolization (BAE) is now safer and may be good for chronic hemoptysis as well.

Ten patients (6 male, 4 female) with hemoptysis underwent BAE. Five patients had massive life-threatening hemoptysis (4 tuberculosis and 1 bronchogenic carcinoma) and 5 had chronic hemoptysis (4 tuberculosis and 1 bronchogenic carcinoma). All patients received BAE by transfemoral arterial approach using gelfoam particles and Ivalon as the embolized materials. Bronchial arteries were abnormal in all cases except one patient who had bronchogenic carcinoma supplied by the acromiothoracic artery to the left upper lobe.

Chest radiograph may correlate well with angiographic findings if there is one lobar lesion, but multiple lobar lesions showed no correlation between the two modalities. Hypervascularity was a universal findings in all patients. Other angiographic findings were enlarged bronchial or nonbronchial arteries, systemic to pulmonary anastomosis, pseudoaneurysm, and extravasation of contrast media. The immediate result of BAE achieved 100 per cent but follow-up showed only a 70 per cent success rate with one mortality from recurrent massive hemoptysis and two recurrent cases due to complications. Ivalon which is a permanent embolized material may be useful for recurrent hemoptysis.