Treatment of Massive Hemoptysis by Embolization of Bronchial and/or Intercostal Arteries

Abstract

Since April 1977, systemic artery embolization was performed to control hemoptysis with use of gelform on 66, and stainless steel coil on 21 patients. Recurrence of hemoptysis within one year was noted in 18 patients out of 54 gelform cases and six out of 21 coil cases. Most often found on following angiography was recanalization in gelform cases, another unembolized systemic artery, intercostal or bronchial in coil cases whether or not hemoptysis recurred. Hemoptysis recurred in higher incidence in active tuberculosis and pulmonary mycosis, and the incidence was 4 out of 7 active tuberculosis, and 3 out of 4 mycosis, comparing with that of old tuberculosis or bronchiectasis, that is 6 out of 20 and 4 out of 14 respectively.Twelve patients underwent surgical resection after embolization successfully, especially when surgery was done within two weeks. Pneumonectomy was required only in two cases according to the extent of diseases. Lobectomy was the most often performed mode of operation which was done on 9 cases. In one case segmentectomy was the satisfactory resection.As for the complication of the embolization no spinal cord injury was noted in this series of cases, even when intercotal arteries were embolized intentionally. (Author's)