Treatment Of Massive Hemoptysis Research Articles

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

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)

Treatment of Massive Hemoptysis by Embolization of Bronchial Arteries

Treatment of Massive Hemoptysis by Embolization of Bronchial Arteries

Treatment of massive hemoptysis with intravenous pitressin

We describe a healthy young male with a normal chest roentgenogram who had repeated massive hemoptyses, probably from a small area of bronchitis, several years after his father had a strikingly similar series of such episodes. On three occasions the bleeding ceased promptly after intravenous administration of pitressin.

Treatment of massive hemoptysis by combined occlusion of pulmonary and bronchial arteries.

Massive, life-threatening hemoptysis occurred in a patient with left upper lobe bronchiectasis secondary to old tuberculosis. Selective left bronchial arteriography showed extravasation of contrast medium in the bronchiectatic area. A marked decrease in hemoptysis occurred after selective left bronchial arterial embolization. Complete cessation of bleeding followed the inflation of a Swan-Ganz balloon catheter that had been placed in the left main pulmonary artery.

Effect of bronchial artery enbolization in the treatment of massive hemoptysis.

Background: Massive hemoptysis is a major clinical problem with high mortality. Bronchial artery embolization is well accepted and widely used for treatment of massive and recurrent hemoptysis, especially in patients with chronic diffuse pulmonary disease who are poor candidates for surgery. We evaluated the therapeutic effect of transcatheter arterial embolization for immediate control and prevention of recurrent hemoptysis. Method: We reviewed 20 cases(M:F=13:7) of bronchial artery embolization for the management of massive hemoptysis from Jun 1989 to Aug 1992 retrospectively. Results: Underlying causes of hemoptysis were pulmonary tuberculosis(n=14), bronchiectasis(n=3), aspergilloma(n=2) and paragonimiasis(n=1). Embolization material was choosed randomly gelfoam(n=7) or Ivalon(n=11) and in 2 cases both were used simultaneously. Target arteries of embolization were bronchial artery only in 15 cases, non-bronchial systemic arteries with or without bronchial artery in 5 cases. After the arterial embolization, immediate cessation of hemoptysis was achieved in 17 cases(85%) and total recurrence rate including 3 cases of immediate treatment failure was 50%. Among recurrences 3 cases were achieved lobectomy, 1 case was expired by asphyxia due to massive hemoptysis and remained 6 were managed by medical conservative treatment with no further recurrence of hemoptysis during follow up periods. Conclusion: Bronchial artery embolization for treatment of massive or recurrent hemoptysis was effective in immediate bleeding control. Despite high recurrence rate the rebleeding after embolization was less severe and controllable by conservative management. Bronchial artery embolization is valuable as primary trial to massive hemoptysis.