Embolic agents used for bronchial artery embolisation in massive haemoptysis

Abstract

Massive haemoptysis is a life-threatening disorder that is associated with a high mortality rate. It is mostly caused by bleeding from bronchial circulation. Bronchial artery embolisation is now considered to be the treatment of choice for acute massive haemoptysis. The safety and effectiveness of bronchial artery embolisation for massive haemoptysis has been proved since its first use in 1973. Currently, polyvinyl alcohol (PVA) particles are the most commonly used embolic agent for bronchial artery embolisation worldwide. PVA particles are biocompatible and nonbiodegradable and are considered to be a permanent embolic agent. Gelatin sponge is a temporary embolic agent and can be used as a supplementary agent after initial embolisation with PVA particles. Stainless steel coils are not recommended for embolisation of bronchial artery, although they may be used in the embolisation of internal mammary artery to preserve the normal vascular territory. Recently, the interest in the use of new embolic agents for bronchial artery embolisation is emerging because of inherent limitations of PVA particles as an intravascular embolic agent. Tris-acryl gelatin microspheres are a new embolic agent that is increasingly used for uterine fibroid embolisation. Tris-acryl gelatin microspheres have characteristics that make it an attractive alternative to PVA particles for bronchial artery embolisation. Clinical trials and experimental studies should be performed to explore the safety and efficacy of microspheres for bronchial artery embolisation.