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Original Research |

Clinical and Angiographic Characteristics of 35 Patients with Cryptogenic Hemoptysis

Takahiro Ando, MD.; Masahiro Kawashima, MD.; Kimihiko Masuda, MD, PhD.; Keita Takeda, MD.; Kenichi Okuda, MD.; Junko Suzuki, MD.; Nobuharu Ohshima, MD, PhD.; Hirotoshi Matsui, MD, PhD.; Atsuhisa Tamura, MD, PhD.; Hideaki Nagai, MD, PhD.; Shinobu Akagawa, MD, PhD.; Ken Ohta, MD, PhD.
Author and Funding Information

CONFLICT OF INTERST STATEMENT: The authors declare no conflict of interest associated with this study.

FUNDINGSUPPORT: The authors have not received any funding for this study.

1Center for pulmonary diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan

Correspondence to: Takahiro Ando, M.D.; Center for pulmonary diseases, National Hospital Organization Tokyo National Hospital, 3-1-1 Takeoka, Kiyose, Tokyo, Japan.


Copyright 2017, . All Rights Reserved.


Chest. 2017. doi:10.1016/j.chest.2017.05.007
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Abstract

Background  Hemoptysis can cause a life threatening condition and often need to be treated urgently. Nearly 20% of hemoptysis cases were diagnosed as cryptogenic after clinical investigation. The purpose of this study was to clarify clinical and angiographic characteristics of cryptogenic hemoptysis.

Methods  We retrospectively reviewed medical records of 35 patients admitted to our hospital with cryptogenic hemoptysis from October 2010 to September 2014.

Results  In the 35 cases, bronchial artery embolization was successfully performed in 33 patients (94.3%) while bronchoscopic hemostatic therapy was added in one patient (2.8%) and embolization was not done in one patient (2.8%) because the bronchial artery was too narrow. In successful embolization group, non-rebleeding rate was 97.0% for 20 months. The angiographic findings revealed that the diameter of bronchial arteries was less than 2 mm in 13 patients, 2 to 3 mm in 17 and more than 3 mm in five. Hypervascularization was detected in 29 patients (82.9%), small bronchial aneurysms in eight (22.9%). The amount of hemoptysis was slight (< 50 mL / day) in 12, mild (50 - 100 mL / day) in 11, moderate (100 - 200 mL / day) in 8 and massive (> 200 mL / day) in 4 patients. No obvious relationship was found between the diameter of bronchial arteries and the amount of hemoptysis.

Conclusion  BAE was highly effective for the management of cryptogenic hemoptysis. Most cases of cryptogenic hemoptysis have angiographic abnormalities, including small or micro aneurysms which were suspected as the cause in some cases.


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