To report our experience with bronchial artery embolization (BAE) in the management of moderate recurrent and life threatening hemoptysis.SETTING: Assiut University hospital.PATIENTS AND METHODS: Retrospective analysis of the demographics, clinical presentation, radiographic studies, bronchoscopy, and complications of bronchial arteriography and/or BAE, in our center, was performed during the period 1998 to 2003.
One hundred forty-six patients underwent bronchial arteriography from 1998 to 2003 in our center for the management of moderate recurrent or life-threatening hemoptysis. BAE was performed in 141 patients. Their mean age was 43 years (range, 17 to 79 years). Active or inactive pulmonary tuberculosis was the most common etiology for hemoptysis followed by bronchiectasis, mycetoma and other identified etiologies, while cryptogenic hemoptysis was recorded in 5 cases. The most common angiographic sign for hemoptysis was hypervascularity (96.6%), followed by systemic-pulmonary artery shunt (40%) and pulmonary artery aneurysm (3.4%). All cases with systemic-pulmonary shunt showed a sharp cut-down of pulmonary arterial blood flow with retrograde filling of pulmonary artery from systemic arteries. The main source of hemoptysis in our patients was bronchial arteries. BAE was effective in immediate cessation of hemoptysis in 112 patients (79%). Recurrence of hemoptysis was observed in 29 cases (21%). Two or more settings of BAE were performed in 50 patients (35%), either due to recurrence of haemoptysis or to complete the embolization procedure for all bleeding arteries. Complications of BAE were in the form of self-limited acute and subacute complications, while chronic complications were not recorded during the course of this study.
We conclude that BAE is an effective line for control of life-threatening or moderate recurrent hemoptysis and its complications are usually self-limited and do not need specific intervention.
G.M. Rabie, None.