Bronchial Arteriography and Transcatheter Embolization in the Management of Hemoptysis

Purpose. The purpose of this study was to determine the factors influencing the effect of bronchial artery embolization in treating massive hemoptysis and the value of bronchial arteriography in the evaluation of patients with hemoptysis.Methods. Thirty-five patients with acute hemoptysis were evaluated by means of bronchial arteriography and treated with transcatheter embolization. Specific causes for bleeding were bronchiectasis (17), lung cancer (9), tuberculosis (4), tetralogy of Fallot (1), and idiopathic hemoptysis (4). The materials used for embolization were gelatin sponge in 33 patients, dextran microspheres in 2, and stainless coils in 1.Results. The angiographic signs of hemorrhage encountered were extravasation of contrast media (14.2%), hypervascularization (94.5%), bronchopulmonary shunts (34.2%), and bronchial artery aneurysms (14.2%). Immediate control of bleeding occurred in 32 (91.4%) of 35 patients after embolization. The rate of recurrent hemoptysis was 20.0% after 2 weeks of the procedure, but the hemorrhage was less severe than before treatment.Conclusion. The data suggest that bronchial artery embolization is an effective method for managing patients with hemoptysis. Minor bleeding recurrences appear to be relatively frequent.