%0 Journal Article
%T Bronchial and Nonbronchial Systemic Artery Embolization in Management of Hemoptysis: Experience with 348 Patients
%A Gamal M. Agmy
%A Safaa M. Wafy
%A Sherif A. A. Mohamed
%A Yaser A. Gad
%A Hisham Mustafa
%A Abd El-Salam Abd El-Aziz
%J ISRN Vascular Medicine
%D 2013
%R 10.1155/2013/263259
%X Background. We aimed to report our experience with bronchial artery embolization (BAE) in the management of moderate recurrent and/or life-threatening hemoptysis. Methods. We evaluated the demographics, clinical presentation, radiographic studies, short- and long-term efficacy, and complications in patients Who underwent BAE, at a tertiary university hospital, from 2003 to 2012. Results. Three hundred forty-one patients underwent BAE for the management of moderate recurrent or life-threatening hemoptysis. Pulmonary TB and bronchiectasis were the most common etiologies for hemoptysis in our locality. The most common angiographic signs for hemoptysis were hypervascularity and systemic-pulmonary artery shunt. BAE was successful in controlling hemoptysis immediately in 95% of patients and at 1 month in 90% of patients. Recurrence of hemoptysis was observed in 9.6% of patients, and reembolization was indicated in 85% of those cases. Complications of BAE were self-limited acute and subacute complications, while chronic complications were not recorded during this study. Conclusions. TB and bronchiectasis are the commonest etiologies for moderate recurrent or life-threatening hemoptysis in our locality. Hypervascular lesions from the bronchial arteries and nonbronchial systemic arteries represented the major vascular abnormalities. Bronchial and nonbronchial systemic artery embolizations were effective to control both acute and chronic hemoptyses, with no serious complications. 1. Introduction Hemoptysis, when massive and untreated, has a mortality rate of >50% [1]. In the majority of cases, the source of massive hemoptysis is the bronchial circulation. However, nonbronchial systemic arteries can be also a significant source [2]. Bronchial artery embolization (BAE) involves selective bronchial artery catheterization and angiography, followed by embolization of any identified abnormal vessels to stop the bleeding. It is a safe and effective nonsurgical therapeutic option for patients with massive hemoptysis. Nonbronchial systemic arteries, however, can be a significant source of massive hemoptysis and a cause of recurrence after successful BAE. Chronic recurrent hemoptysis can occur in chronic lung disorders such as bronchiectasis and tuberculosis in which hemoptysis is troublesome though not immediately lifethreatening [3]. Recent studies [3¨C5] have confirmed the effectiveness of BAE in the management of moderate (more than or equal to three episodes of 100£żmL of bleeding per day within 1 week) and even mild (chronic or slowly increasing) hemoptysis cases.
%U http://www.hindawi.com/journals/isrn.vascular.medicine/2013/263259/