Abstract No. 347: Use of contrast-enhanced computed tomography in patients with hemoptysis requiring bronchial artery embolization

Abstract

The purpose of the study is to evaluate the efficacy of contrast-enhanced CT scan for patients with massive hemoptysis requiring bronchial artery embolization. In our institution, over a 3½-year period (January 2008 to June 2011), 19 patients (15 males and 4 females, age of 4–82 years old) presented with massive hemoptysis having bronchial artery embolization had contrast-enhanced CT scans performed within 3 months. The causes and sites of bleeding, as well as the size of the bronchial and non-bronchial systemic arteries were identified on the CT scans. The results of the bronchial artery embolization were reviewed. Correlations of the results of the CT scan and the bronchial artery embolization were evaluated. The causes of hemoptysis could be identified on the CT scan in 18 out of these 19 patients. Two-thirds of them had bronchiectasis, while the others had carcinoma of lung, aspergillus infection, old tuberculosis and congenital cyanotic heart disease. Ten patients had bilateral diseases while the rest had single lung involvement. These patients had proceeded to bronchial artery embolization. Four out of 19 patients had no embolization performed subsequently, due to either failed cannulation of the bronchial arteries or normal looking vessels on bronchial artery angiograms with very minute (<1.8mm) bronchial arteries on the CT scans. For the other 15 patients, bronchial artery embolization were performed on both sides in 5 patients, and on one side in 10 patients. These patients had hypertrophied (>1.8mm) arteries identified on the CT scan. Four patients had actually hypertrophied intercostal arteries and another one with hypertrophied right axillary artery. There are excellent correlations between the results of the contrast-enhanced CT scan and the angiogram. CT scan is useful in identifying the pulmonary diseases, as well as the site and size of the bronchial and non-bronchial arteries causing the bleeding. This will facilitate bronchial artery catheterization and subsequent embolization and thus shortens the procedure time.