Top

European Radiology

Published in:

01-03-2010 | Vascular-Interventional

Immediate and long-term outcomes of bronchial and non-bronchial systemic artery embolisation for the management of haemoptysis

Authors: Joo-Young Chun, Anna-Maria Belli

Published in: European Radiology | Issue 3/2010

Abstract

Objective

To evaluate the immediate and long-term results of arterial embolisation in the management of haemoptysis and to identify factors influencing outcome.

Methods

A retrospective analysis was carried out of the medical records and angiograms of 50 patients who underwent transarterial embolisation for haemoptysis.

Results

The most frequent causes of haemoptysis included bronchiectasis (16%), active tuberculosis (12%) and aspergilloma (12%). A total of 126 bronchial and non-bronchial systemic arteries were embolised in 62 procedures. Immediate cessation of haemoptysis was achieved in 43 patients (86%). Haemoptysis was controlled in 36 patients (72%), recurred in 14 (28%) and 11 (22%) required repeat embolisation. The worst outcomes were observed in patients with aspergilloma: all six suffered recurrent bleeding and three (50%) died from massive haemoptysis. Aspergilloma was also associated with an increased risk of haemoptysis recurrence (p < 0.05). A good clinical outcome was achieved in those with active tuberculosis and malignancy. Complication rates were low and included transient chest pain, false aneurysm and one case of lower limb weakness.

Conclusion

Bronchial artery embolisation (BAE) is an effective and safe procedure for haemoptysis control in most cases. However, high recurrence and mortality rates are associated with aspergilloma. Early intervention with repeat embolisation is recommended in these patients and elective surgery should be considered.

Crocco JA, Rooney JJ, Fankushen DS et al (1968) Massive hemoptysis. Arch Intern Med 121:495–498CrossRefPubMed

Najarian KE, Morris CS (1998) Arterial embolization in the chest. J Thorac Imaging 13:93–104CrossRefPubMed

Fernando HC, Stein M, Benfield JR et al (1998) Role of bronchial artery embolization in the management of haemoptysis. Arch Surg 133:862–866CrossRefPubMed

Yu-Tang Goh P, Lin M, Teo N et al (2002) Embolization for hemoptysis: a six-year review. Cardiovasc Intervent Radiol 25:17–25CrossRefPubMed

Rémy J, Arnaud A, Fardou H et al (1977) Treatment of hemoptysis by embolization of bronchial arteries. Radiology 122:33–37PubMed

Uflacker R, Kaemmerer A, Picon PD et al (1985) Bronchial artery embolization in the management of hemoptysis: technical aspects and long-term results. Radiology 157:637–644PubMed

Rabkin JE, Astafjev VI, Gothman LN et al (1987) Transcatheter embolization in the management of pulmonary hemorrhage. Radiology 163:361–365PubMed

Katoh O, Lishikawa T, Yamada H et al (1990) Recurrent bleeding after arterial embolization in patients with hemoptysis. Chest 97:541–546CrossRefPubMed

Hayakawa K, Tanaka F, Torizuka T et al (1992) Bronchial artery embolization for hemoptysis: immediate and long-term results. Cardiovasc Intervent Radiol 15:154–159CrossRefPubMed

10.

Ramakantan R, Bandekar VG, Gandhi MS et al (1996) Massive hemoptysis due to pulmonary tuberculosis: control with bronchial artery embolization. Radiology 200:694

11.

Mal H, Rullon I, Mellot F et al (1999) Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Chest 115:996–1001CrossRefPubMed

12.

Swanson KL, Johnson M, Prakash UB et al (2002) Bronchial artery embolization: experience with 54 patients. Chest 121:789–795CrossRefPubMed

13.

Poyanli A, Acunas B, Rozanes I et al (2007) Endovascular therapy in the management of moderate and massive haemoptysis. Br J Radiol 80:331–336CrossRefPubMed

14.

Kato A, Kudo S, Matsumoto K et al (2000) Bronchial artery embolization for hemoptysis due to benign diseases: immediate and long-term results. Cardiovasc Intervent Radiol 23:351–357CrossRefPubMed

15.

Osaki S-I, Nakanishi Y, Wataya H et al (2008) Prognosis of bronchial artery embolization in the management of hemoptysis. Respiration 67:412–416CrossRef

16.

Kim YG, Yoon H-K, Ko GY et al (2006) Long-term effect of bronchial artery embolization in Korean patients with haemoptysis. Respirology 11:776–781CrossRefPubMed

17.

Yoon W, Kim JK, Kim YH et al (2002) Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review. Radiographics 22:1395–1409CrossRefPubMed

18.

Sbano H, Mitchell A, Ind P et al (2005) Peripheral pulmonary artery pseudoaneurysms and massive hemoptysis. AJR Am J Roentgenol 184:1253–1259PubMed

19.

Yoon YC, Lee KS, Jeong YJ et al (2005) Hemoptysis: bronchial and nonbronchial systemic arteries at 16-detector row CT. Radiology 234:292–298CrossRefPubMed

20.

Rémy-Jardin M, Bouaziz N, Dumont P et al (2004) Bronchial and nonbronchial systemic arteries at multi-detector row CT angiography: comparison with conventional angiography. Radiology 233:741–749CrossRefPubMed

Title: Immediate and long-term outcomes of bronchial and non-bronchial systemic artery embolisation for the management of haemoptysis
Authors: Joo-Young Chun
Anna-Maria Belli
Publication date: 01-03-2010
Publisher: Springer-Verlag
Published in: European Radiology / Issue 3/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-009-1591-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Immediate and long-term outcomes of bronchial and non-bronchial systemic artery embolisation for the management of haemoptysis

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2010

CT colonography for synchronous colorectal lesions in patients with colorectal cancer: initial experience

Carcinoma of the breast wire localisation post nuclear medicine sentinel lymph node imaging. Are radiologists receiving a significant dose?

High resolution myocardial magnetic resonance stress perfusion imaging at 3 T using a 1 M contrast agent

Retrospective analysis of patients for development of nephrogenic systemic fibrosis following conventional angiography using gadolinium-based contrast agents

Computer-aided detection (CAD) of lung nodules in CT scans: radiologist performance and reading time with incremental CAD assistance

Erratum to: Tumour and tumour-like lesions of the patella - a multicentre experience