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title:Role of Bronchial Artery Embolization in the Management of Hemoptysis

Author:Niranjan Narasimhalu, Malay Sarkar, Rajeev Bhardwaj, Rameshwarsingh Negi, Sunil Sharma

Keywords:BA - Bronchial Artery BAE - Bronchial Artery Embolization CXR - Chest-X-Ray CT - Compturized Tomopraphy FOB - Fibroptic Bronchoscopy HB - Hemoglobin HIV - Human Immunodeficiency Virus ICA - Intercostal Artery IMA - Internal Mammary Artery LT

Type:Original Article

Abstract:Objective: the goal of this study was to assess the effectiveness and safety of bronchial (BAE) and/or non-bronchial (NBAE) systemic artery embolization in the management of hemoptysis, and the recurrence of hemoptysis within 3 months after embolization therapy. Material & Methods: A total of thirty patients who presented with various degrees of hemoptysis (massive, severe, moderate and mild) underwent bronchial artery embolization (BAE) / nonbronchial (NBAE) systemic artery embolization from July 2013 to June 2014. The effectiveness, safety, and the materials used in the embolization procedures were recorded along with short-term relapse. Results: Most of the patients had severe hemoptysis, reported in 16 (53.3%) cases, nine patients had massive (30%) and 5 (16.7%) patients had moderate hemoptysis. Hemoptysis was caused by tubercular sequelae (except aspergilloma) in 19 patients, active tuberculosis in 7patients, and aspergilloma and bronchogenic carcinoma in 2 patients each. A total of 70 arteries were embolized in 30 patients including 32 (46%) bronchial and 38 (54%) non-bronchial systemic arteries. The average number of arteries embolized per patient was 2.3. Complete resolution of hemoptysis was achieved within 24 hours in all 30 patients (100%). Rebleeding occurred within 30 days in seven patients. Only one patient had recurrent hemoptysis that occurred 30 days after the procedure. Chest pain was the most common post-embolization complication reported. Conclusion: Embolization therapy with appropriate technique is a safe and well-tolerated procedure with minor complications. It is important to embolize nonbronchial systemic arteries at the same setting, if they are angiographically shown to be contributing to hemoptysis.

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