| Effect of Bronchial Artery Embolization in the Treatment of Massive Hemoptysis |
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Sang Kyeong Lee1, Ho Kee Chun1, Ki Heon Yoon1, Jee Hong Yoo1, Hong Mo Kang1, Yup Yoon2 |
1Department of Internal Medicine, Kyunghee University, Seoul, Korea School of Medicine.
2Department of Diagnostic Radiology, Kyunghee University, Seoul, Korea School of Medicine. |
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| Abstract |
Background
Massive hemoptysis is a major clinical problem with high mortality. Bronchial artery embolization is well accepted and widely used for treatment of massive and recurrent hemoptysis, especially in patients with chronic diffuse pulmonary disease who are poor candidates for surgery. We evaluated the therapeutic effect of transcatheter arterial embolization for immediate control and prevention of recurrent hemoptysis.
Methods
We reviewed 20 cases (M: F= 13: 7) of bronchial artery embolization for the management of massive hemoptysis from Jun 1989 to Aug 1992 retrospectively.
Results
Underlying causes of hemoptysis were pulmonary tuberculosis (n=14) , bronchiectasis (n= 3), aspergilloma (n = 2) and paragonimiasis (n = 1). Embolization material was choosed randomly gelfoam (n=7) or Ivalon (n=ll) and in 2 cases both were used simultaneously. Target arteries of embolization were bronchial aπery only in 15 cases, non-bronchial systemic arteries with or without bronchial aπery in 5 cases. After the arterial embolization, immediate cessation of hemoptysis was achieved in 17 cases (85%) and total recurrence rate including 3 cases of immediate treatment failure was 50% . Among recurrences 3 cases were achieved lobectomy, 1 case was expired by asphyxia due to massive hemoptysis and remained 6 were managed by medical conservative treatment with no further recurrence of hemoptysis during follow-up periods.
Conclusion
Bronchial artery embolization for treatment of massive or recurrent hemoptysis was effective in immediate bleeding control. Despite high recurrence rate the rebleeding after embolization was less severe and controllable by conservative management. Bronchial artery embolization is valuable as primary trial to massive hemoptysis. |
| Key Words:
Bronchial artery embolization, Massive hemoptysis |
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