Tuberc Respir Dis.  1996 Aug;43(4):590-599. 10.4046/trd.1996.43.4.590.

Effect of bronchial artery embolization in the management of massive hemoptysis : factors influencing rebleeding

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea.
  • 2Department of Diagnostic Radiology, College of Medicine, Hanyang University, Seoul, Korea.

Abstract

BACKGROUND
Bronchial artery embolization has been established as an effective means to control hemoptysis, especially in patients with decreased pulmonary function and those with advanced chronic obstructive pulmonary disease. We evaluated the effect of arterial embolization in immediate control of massive hemoptysis and investigated the clinical and angiographic characteristics and the course of patients with reccurrent hemoptysis after initial succeseful embolization. Another purpose of this study was to find predictive that cause rebleeding after bronchial artery embolization. METHOD: We reviewed 47 cases that underwent bronchial artery embolization for the management of massive hemoptysis, retrospectively. We analyzed angiographic findings in all cases before bronchial artery embolization and also reviewed the angiographic findings of patients that underwent additional bronchial artery embolization for the control of reccurrent hemoptysis to find the causes of rebleeding.
RESULTS
1) Underlying causes of hemoptysis were pulmonary tuberculosis (n=35), bronchiectasis(n=5), aspergilloma(n=2), lung cancer(n=2), pulmonary A-V malformation(n=l), and unknown cases(n=2). 2) Overal immediate success rate was 94%(n=44), and recurrence rate was 40%(n=19). 3) The prognostic factors such as bilaterality, systemic-pulmonary artery shunt, multiple feeding arteries and degree of neovascularity were not statistically correlated with rebleeding tendency. (p value>0.05). 4) At additional bronchial artery embolization, Revealed recannalization of previous embolized arteries were 14/18cases(78%) and the presence of new feeding arteries was 8/18cases(44%). 5) The complications(31cases, 66%) such as fever, chest pain, cough, voiding difficulty, paralytic ileus, motor and sensory change of lower extremity, atelectasis and splenic infarction were occured.
CONCLUSION
Recannalization of previous embolized arteries is the major cause of recurrence after bronchial artery embolization. Despite high recurrence rate of hemoptysis, bronchial artery embolization for management of massive hemoptysis is a effective and safe procedure in immediate bleeding control.

Keyword

hemoptysis; bronchial artery embolization

MeSH Terms

Arteries
Bronchial Arteries*
Chest Pain
Cough
Fever
Hemoptysis*
Hemorrhage
Humans
Intestinal Pseudo-Obstruction
Lower Extremity
Lung
Pulmonary Atelectasis
Pulmonary Disease, Chronic Obstructive
Recurrence
Retrospective Studies
Splenic Infarction
Tuberculosis, Pulmonary
Full Text Links
  • TRD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr