While bronchial arterial embolization(BAE) has been found to be useful in controlling acute massive hemoptysis, its role in non-acute cases has not been well studied. A study has been carried out toevaluate the safety and efficacy of BAE performed on non-acute haemoptysis, in comparison to those performed during acute situations.
Hospital records of all patients undergone BAE in our hospital from 1999-2002 were studied. Cases were classified by the timing of the procedure in relation to their emergency admission for hemoptysis. Procedures performed more than 48 hours after admission and with hemoptysis subsided were classified as “non-acute”, which also included cases of chronic haemoptysis. Demographics data, co-morbidities, etiologies for hemoptysis, numbers of blood vessels embolized, immediate results and complications were recorded. Chi-square test was employed in statistical analysis for non-numerical variables, while independent t test and Mann-Whitney U test were used for numerical variables.
Sixty-two bronchial arteriograms were performed in 59 patients. Forty-seven (75.8%) were classified as non-acute while 15 (24.2%) acute. Forty-eight (81.3%) were males (18.7%). Mean age was 64.1(SD=13.4). Bronchiectasis (59.6%) and pulmonary tuberculosis (59.6%) were the commonest underlying etiologies. Medical co-morbidities were present in 8 patients (13.4%), with no significance difference between two groups (p=0.234). BAE was performed in all but 5 cases: two had normal angiographic findings, two with failed attempts and one procedure terminated due to presence of hemomediastinum. Number of embolized blood vessels ranged from 1 to 5, without any signficant difference between the acute and non-acute groups (p=0.214). There were four episodes of complications (6.4%): three intimal dissections and one hemomediastinum. No mortality related to procedure was found. Although all complications occurred in non-acute cases, no statistical significant difference was found (p=0.56). No immediate recurrence of hemoptysis during that admission was found in all acute and non-acute procedures.
BAE appeared to be safe and useful in the control of both acute and non-acute hemoptysis.
BAE can be considered for cases of recurrent troublesome chronic hemoptysis.
S. Lee, None.