Educational ExhibitAbstract No. 347 - Intraluminal brachytherapy for the treatment of malignant biliary obstruction –- the role of the interventional radiologist

Abstract

No. 348 A retrospective analysis of 334 cases of hemoptysis treated by bronchial artery embolization A.S. Bhalla, D. Kandasamy, P.T. Veedu, A. Mohan, S. Gamanagatti; Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India; Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Science, New Delhi, India Purpose: To analyze the safety, efficacy and outcome of bronchial artery embolization(BAE) in the management of patients with hemoptysis. Materials and Methods: A retrospective study of 334 patients for whom BAE was performed for hemoptysis from January 2007 to July 2013. Study included 255 (76.3%) males and 79 (23.7%) females and age ranged from 5 81yrs (mean 40). Polyvinyl alcohol (PVA, 300-1000μm) was used in all patients and gel foam was used in combination with PVA where there was significant shunting. All relevant arteries were evaluated but only those arteries which showed hypertrophy and significant blush were targeted Results: Mild hemoptysis was seen in 70 patients, moderate in 195 and severe in 69 patients. On imaging right side disease was seen in 101 patients, left side involvement in 59 patients and bilateral involvement in 174 patients. Right upper zone involvement was the most frequent occurrence seen in 229 patients. Post tuberculosis changes were the predominant pathology and it was seen in 248 patients. Among 334 patients (386 procedures) 42 patients underwent the procedure twice and 5 patients underwent thrice. Total of 485 arteries were attempted of which 440 arteries were successfully embolized whereas the rest 42 arteries could not be cannulated because of technical difficulty and 3 arteries went in to spasm. Right intercostobronchial (RICB) was the commonest culprit artery which was present in 157 patients which is followed by common bronchial (97), left bronchial (55), right bronchial (45) and others. We embolized a maximum of 4 arteries in one session. Immediate complications such as dissection and rupture were observed only in 9 sessions (2.3%) in which no intervention was needed. Twenty-five procedures (6.5%) were repeated within 2 months which were due to technical or clinical failure of the procedure. Twenty-seven procedures (7%) were repeated after 2 months which represented clinical recurrence of the disease. Posters and Exhibits ’ JVIR S156 P os te rs an d Ex hi bi ts