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Sheehan F, Graham A, Tait NP, Ind P, Alsafi A, Jackson JE. Bronchial artery embolization using small particles is safe and effective: a single center 12-year experience. Eur Radiol 2024:10.1007/s00330-024-10836-y. [PMID: 38861163 DOI: 10.1007/s00330-024-10836-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/21/2024] [Accepted: 05/04/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Bronchial artery embolization (BAE) using particles is an established treatment for hemoptysis. The use of polyvinyl alcohol (PVA) with a particle size of 300 µm or larger is thought to reduce the risk of non-target embolization but may result in more proximal vessel occlusion than is ideal, resulting in a high rate of early recurrent hemorrhage. OBJECTIVE This study evaluates the safety and efficacy of BAE using PVA particles with a size of less than 300 µm. METHODS All patients who underwent BAE between 2010 and 2022 at a tertiary center were included. Demographic data, etiology and volume of hemoptysis, technical and clinical success, procedure-related complications, and follow-up information were collected from patients' electronic records. 150-250 µm PVA particles were used to commence embolization in all patients with the subsequent use of larger-sized particles in some individuals. The Kaplan-Meier method was used to estimate recurrence and survival rates. RESULTS One hundred forty-four patients underwent 189 embolization procedures between 2010 and 2022 and were followed up for a median of 35 months [IQR 19-89]. 150 µm to 250 µm PVA particles were used as the sole embolic agent in 137 cases. Hemoptysis recurred within 30 days in 7%. The median time to repeat intervention was 144 days [IQR 42-441]. Seventeen out of 144 patients had a pulmonary artery branch pseudoaneurysm. The rate of major complications was 1% with no instances of stroke or spinal artery ischemia. Thirty-day mortality was 2% (4/189). CONCLUSION BAE using 150-250 µm PVA particles is safe and effective with few complications and low rates of early hemoptysis recurrence. CLINICAL RELEVANCE STATEMENT BAE using small particles is likely to improve outcomes, particularly the rate of early recurrence, in patients with hemoptysis, without an increase in procedural complications. KEY POINTS BAE is a safe and effective treatment for patients with hemoptysis. Using small PVA particles in BAE has few complications and low rates of early recurrence. Pulmonary artery pseudoaneurysms should be actively sought in those with hemoptysis undergoing BAE.
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Affiliation(s)
- Frances Sheehan
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK
| | - Alison Graham
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK
| | - N Paul Tait
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK
| | - Philip Ind
- Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Ali Alsafi
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK.
- Department of Surgery and Cancer, Imperial College London, London, UK.
| | - James E Jackson
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK
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Zhang Q, Li J, He G, Tang J, Zhang G. Utility of intra-procedural cone-beam computed tomography imaging for the determination of the artery of Adamkiewicz suspected by angiography during transarterial embolization for hemoptysis. Diagn Interv Radiol 2023; 29:713-718. [PMID: 36994610 PMCID: PMC10679543 DOI: 10.4274/dir.2022.221646] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/16/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE To evaluate the role of cone-beam computed tomography (CT) performed for the determination of the artery of Adamkiewicz (AKA) suspected by angiography during trans-catheter bronchial artery embolization for hemoptysis. METHODS In this retrospective study, 17 patients with hemoptysis who underwent cone-beam CT for evaluation of the AKA prior to arterial embolization from December 2014 to March 2022 were included. During the angiographic session, two interventional radiologists selected the possible AKAs that were defined as obscured hairpin-curved vessels arising from the dorsal branch of the intercostal arteries and running towards the midline in the arterially enhanced phase. Contrast-enhanced cone-beam CT was performed as an adjunct to angiography to determine whether the indefinite AKA was a real AKA based on whether it was found to connect to the anterior spinal artery. RESULTS Selective cone-beam CT was performed at 17 possible AKAs detected by selective arteriogram of the intercostal artery (ICA). Cone-beam CT allowed for the determination of AKAs in 16 cases (94.1%). As a result of cone-beam CT findings, 9 of 16 study arteries (56.3%) were judged as definite AKAs, and the remaining 7 (43.7%) were judged as definitely not AKAs but as the musculocutaneous branching from the dorsal branch of the ICA. In 1 of 17 cases (5.9%), cone-beam CT could not determine the AKA because of poor image quality caused by inadequate breath holding. An additional anterior radiculomedullary artery arising from the dorsal branch of the lower ICA because of the inflow of the contrast medium through the anastomosis was detected in one case by conebeam CT but not by angiography. CONCLUSION Intraprocedural enhanced cone-beam CT performed as an adjunctive technique to angiography is sufficient for confident determination of the AKA, which is essential for the operators to perform accurate and safe arterial embolization for hemoptysis.
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Affiliation(s)
- Qingmeng Zhang
- Department of Emergency, Qilu Hospital of Shandong University, Shandong, China
| | - Jijun Li
- Department of Interventional Radiology, Shandong First Medical University Affiliated Provincial Hospital, Shandong, China
| | - Guanghui He
- Department of Thoracic Surgery Division of Interventional Radiology, WeiFang People’s 2nd Hospital, Shandong, China
| | - Jun Tang
- Department of Interventional Radiology, Shandong First Medical University Affiliated Provincial Hospital, Shandong, China
| | - Guodong Zhang
- Department of Interventional Radiology, Shandong First Medical University Affiliated Provincial Hospital, Shandong, China
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Herrera DG, Ostad BJ, Wilkins LR, Sheeran DP, Park AW, Goode AR, Patrie JT, Angle JF. Effect of computed tomography angiography prior to bronchial embolization on radiation dose and recurrent hemoptysis. Clin Imaging 2023; 100:48-53. [PMID: 37207442 DOI: 10.1016/j.clinimag.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/10/2023] [Accepted: 04/13/2023] [Indexed: 05/21/2023]
Abstract
PURPOSE To investigate whether pre-procedure Computed Tomography Angiography (CTA) improves radiation exposure, procedure complexity, and symptom recurrence after bronchial embolization for massive hemoptysis. MATERIAL AND METHODS A single-center retrospective review of bronchial artery embolization (BAE) for massive hemoptysis was performed for procedures between 2008 and 2019. Multi-variate analysis was performed to determine the significance of pre-procedure CTA and etiology of hemoptysis on patient radiation exposure (reference point air kerma, RPAK) and rate of recurrent hemoptysis. RESULTS There were 61 patients (mean age 52.5 years; SD = 19.2 years, and 57.3% male) and CTA was obtained for 42.6% (26/61). Number of vessels selected was a mean of 7.2 (SD = 3.4) in those without CTA and 7.4 (SD = 3.4) in those with CTA (p = 0.923). Mean procedure duration was 1.8 h (SD = 1.6 h) in those without CTA and 1.3 h (SD = 1.0 h) in those with CTA (p = 0.466). Mean fluoroscopy time and RPAK per procedure were 34.9 min (SD = 21.5 min) and 1091.7 mGy (SD = 1316.6 mGy) for those without a CTA and 30.7 min (SD = 30.7 min) and 771.5 mGy (SD = 590.0 mGy) for those with a CTA (p = 0.523, and p = 0.879, respectively). Mean total iodine given was 49.2 g (SD = 31.9 g) for those without a CTA and 70.6 g (SD = 24.9 g) for those with a CTA (p = 0.001). Ongoing hemoptysis at last clinical follow up was 13/35 (37.1%) in those without CTA and 9/26 (34.6%) in those with CTA (p = 0.794). CONCLUSIONS Pre-procedure CTA did not improve radiation effective dose and symptom recurrence after BAE and is associated with significant increases in total iodine dose.
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Affiliation(s)
- Daniel Giraldo Herrera
- University of Virginia Health System, Department of Radiology and Medical Imaging, Division of Interventional Radiology, United States of America.
| | - Bahrom J Ostad
- University of Virginia Health System, Department of Radiology and Medical Imaging, Division of Interventional Radiology, United States of America
| | - Luke R Wilkins
- University of Virginia Health System, Department of Radiology and Medical Imaging, Division of Interventional Radiology, United States of America
| | - Daniel P Sheeran
- University of Virginia Health System, Department of Radiology and Medical Imaging, Division of Interventional Radiology, United States of America
| | - Auh Whan Park
- University of Virginia Health System, Department of Radiology and Medical Imaging, Division of Interventional Radiology, United States of America
| | - Allen R Goode
- University of Virginia Health System, Department of Radiology and Medical Imaging, Division of Diagnostic Medical Physics, United States of America
| | - James T Patrie
- University of Virginia School of Medicine, Department of Public Health Sciences, United States of America
| | - John F Angle
- University of Virginia Health System, Department of Radiology and Medical Imaging, Division of Interventional Radiology, United States of America
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Role of Bronchial Artery Embolization as Early Treatment Option in Stable Cystic Fibrosis Patients with Sub-Massive Hemoptysis: Personal Experience and Literature Review. J Clin Med 2022; 11:jcm11216432. [PMID: 36362659 PMCID: PMC9657817 DOI: 10.3390/jcm11216432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/19/2022] [Accepted: 10/27/2022] [Indexed: 11/22/2022] Open
Abstract
(1) Background: We describe our experience with cystic fibrosis (CF) patients treated with bronchial artery embolization (BAE) for sub-massive hemoptysis to understand if early treatment of sub-massive hemoptysis can reduce the volume of any subsequent bleedings. (2) Materials: We performed a retrospective study including CF patients who underwent angiographic procedures for BAE following sub-massive hemoptysis, from March 2016 to December 2021. All patients underwent an initial chest angio-CT study. BAE was realized with microspheres or coils. (3) Results: Thirteen patients were included, subjected to at least one BAE after sub-massive hemoptysis, for a total of 19 procedures. Technical success was 94.7%; in a single case, the catheterization of the bronchial arterial feeder was not achievable and the procedure was repeated. Primary clinical success was 92.3%; secondary clinical success was 69.2%. Relative clinical success was 85%. A higher incidence of recurrent hemoptysis following treatment with coils was observed (100% of cases) compared to treatment with microspheres (54.5% of cases) χ2 = 5.43 (p < 0.05). (4) Conclusions: BAE is a safe and effective method for the treatment of hemoptysis in CF patients; it should be practiced not only after massive or recurrent hemoptysis but also in patients with sub-massive bleeding to improve their life expectancy and quality of life.
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Lee CM, Jeon CH, Lee R, Kwon H, Kim CW, Kim JH, Kim JH, Kim H, Kim SH, Lee CK, Park CY, Bae M. Traumatic Hemothorax Caused by Thoracic Wall and Intrathoracic Injuries: Clinical Outcomes of Transcatheter Systemic Artery Embolization. TAEHAN YONGSANG UIHAKHOE CHI 2021; 82:923-935. [PMID: 36238056 PMCID: PMC9514418 DOI: 10.3348/jksr.2020.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 11/15/2022]
Abstract
Purpose We aimed to assess the clinical efficacy of transcatheter arterial embolization (TAE) for treating hemothorax caused by chest trauma. Materials and Methods Between 2015 and 2019, 68 patients (56 male; mean age, 58.2 years) were transferred to our interventional unit for selective TAE to treat thoracic bleeding. We retrospectively investigated their demographics, angiographic findings, embolization techniques, technical and clinical success rates, and complications. Results Bleeding occurred mostly from the intercostal arteries (50%) and the internal mammary arteries (29.5%). Except one patient, TAE achieved technical success, defined as the immediate cessation of bleeding, in all the other patients. Four patients successfully underwent repeated TAE for delayed bleeding or increasing hematoma after the initial TAE. The clinical success rate, defined as no need for thoracotomy for hemostasis after TAE, was 92.6%. Five patients underwent post-embolization thoracotomy for hemostasis. No patient developed major TAE-related complications, such as cerebral infarction or quadriplegia. Conclusion TAE is a safe, effective and minimally invasive method for controlling thoracic wall and intrathoracic systemic arterial hemorrhage after thoracic trauma. TAE may be considered for patients with hemothorax without other concomitant injuries which require emergency surgery, or those who undergoing emergency TAE for abdominal or pelvic hemostasis.
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Vijayasekaran D, Sivabalan S. Bronchial Dieulafoy Disease with Recurrent Life-threatening Hemoptysis. Indian Pediatr 2021. [PMID: 33713072 PMCID: PMC8005277 DOI: 10.1007/s13312-021-2177-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Martin LN, Higgins L, Mohabir P, Sze DY, Hofmann LV. Bronchial Artery Embolization for Hemoptysis in Cystic Fibrosis Patients: A 17-Year Review. J Vasc Interv Radiol 2019; 31:331-335. [PMID: 31899109 DOI: 10.1016/j.jvir.2019.08.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 08/21/2019] [Accepted: 08/28/2019] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To review safety and efficacy of bronchial artery embolization (BAE) for treatment of hemoptysis in adult patients with cystic fibrosis (CF) and to report 30-day, 1-year, and 3-year outcomes. MATERIALS AND METHODS Between January 2001 and April 2018, 242 patients with CF were evaluated for hemoptysis. Thirty-eight BAEs were performed in 28 patients with hemoptysis. Technical success was defined as freedom from repeat embolization and hemoptysis-related mortality. Clinical success was defined as freedom from repeat embolization and mortality from any cause. Technical and clinical success were examined at 30 days, 1 year, and 3 years after initial BAE. Mean patient age was 32 years, and median follow-up was 4.8 years (range, 10 mo to 16.7 y). RESULTS Technical and clinical success rates at 30 days were 89% (25/28) and 82% (23/28), respectively. Success rates at 1 year were 86% (24/28) and 79% (22/28), respectively, and at 3 years were 82% (23/28) and 75% (21/28), respectively. The 30-day overall complication rate was 7.9% (3/38) with 2.6% (1/38) major complication rate and 5.2% (2/38) minor complication rate. Overall 3-year mortality rate was 25% (7/28). CONCLUSIONS BAE is safe and effective in patients with CF presenting with life-threatening hemoptysis. BAE results in high rates of long-term technical and clinical success in this patient population despite progressive chronic disease. Repeat embolization is necessary only in a minority of patients.
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Affiliation(s)
- Lynne N Martin
- Division of Interventional Radiology, Stanford Medicine, 300 Pasteur Drive, H3630, Stanford, CA 94305.
| | - Luke Higgins
- Division of Interventional Radiology, Stanford Medicine, 300 Pasteur Drive, H3630, Stanford, CA 94305
| | - Paul Mohabir
- Division of Pulmonary and Critical Care Medicine, Stanford Medicine, 300 Pasteur Drive, H3630, Stanford, CA 94305
| | - Daniel Y Sze
- Division of Interventional Radiology, Stanford Medicine, 300 Pasteur Drive, H3630, Stanford, CA 94305
| | - Lawrence V Hofmann
- Division of Interventional Radiology, Stanford Medicine, 300 Pasteur Drive, H3630, Stanford, CA 94305
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8
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Cody O'Dell M, Gill AE, Hawkins CM. Bronchial Artery Embolization for the Treatment of Acute Hemoptysis. Tech Vasc Interv Radiol 2017; 20:263-265. [PMID: 29224659 DOI: 10.1053/j.tvir.2017.10.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Massive hemoptysis is a life-threatening condition often defined as coughing up 300-600mL of blood in 24 hours in an adult, or >8mL/kg in 24 hours in a child. Although the definition is controversial, one should view massive hemoptysis as any volume of expectorated blood that can cause respiratory failure. This is because mortality in the setting of hemoptysis is usually associated with asphyxiation, rather than exsanguination. Massive hemoptysis accounts for only about 5% of cases of hemoptysis, but when treated conservatively, has a reported mortality rate between 50% and 85%. Etiologies vary widely based on demographics. In children, infectious causes predominate in developing countries, and cystic fibrosis predominates among children of European descent. In adults, malignancy, bronchiectasis, and chronic infection are the most common causes. Treatment begins with resuscitation and airway protection, followed by minimally invasive bronchoscopic and endovascular techniques. Surgical interventions are considered last line therapy due to mortality rates of 37%-43% in the setting of massive hemoptysis. Bronchial artery embolization is now considered the treatment of choice for massive hemoptysis.
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Affiliation(s)
- M Cody O'Dell
- Department of Radiology and Imaging Science, Emory University Hospital, Atlanta, GA.
| | - Anne E Gill
- Department of Radiology and Imaging Science, Emory University Hospital, Atlanta, GA
| | - C Matthew Hawkins
- Department of Radiology and Imaging Science, Emory University Hospital, Atlanta, GA
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Malone CD, Ramaswamy RS, Rose SC. Control of massive hemoptysis via a “back-door” approach through the pulmonary artery. Radiol Case Rep 2016; 11:83-5. [PMID: 27257456 PMCID: PMC4878955 DOI: 10.1016/j.radcr.2016.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 03/24/2016] [Indexed: 12/02/2022] Open
Abstract
Bronchial artery embolization is an effective nonsurgical therapy for massive hemoptysis. Routine selection of the bronchial arteries from the aorta usually enables the interventionalist full interrogation and embolization of the culprit vascular abnormality. In problematic cases where bronchial artery access is difficult, a systemic-to-pulmonary arterial shunt can be exploited as a retrograde means of vascular intervention. A case is presented where inaccessibility of a tortuous left bronchial artery was circumvented by accessing the left pulmonary artery, leading to successful embolization and control of hemoptysis.
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10
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Recurrent Bleeding, Survival, and Longitudinal Pulmonary Function following Bronchial Artery Embolization for Hemoptysis in a U.S. Adult Population. J Vasc Interv Radiol 2015; 26:1806-13.e1. [DOI: 10.1016/j.jvir.2015.08.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 08/18/2015] [Accepted: 08/19/2015] [Indexed: 11/19/2022] Open
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Ramírez Mejía AR, Méndez Montero JV, Vásquez-Caicedo ML, Bustos García de Castro A, Cabeza Martínez B, Ferreirós Domínguez J. Radiological Evaluation and Endovascular Treatment of Hemoptysis. Curr Probl Diagn Radiol 2015; 45:215-24. [PMID: 26293972 DOI: 10.1067/j.cpradiol.2015.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 07/16/2015] [Accepted: 07/17/2015] [Indexed: 11/22/2022]
Abstract
Hemoptysis can be a life-threatening condition that warrants urgent investigation and intervention. Common causes include bronchiectasis, chronic obstructive pulmonary disease, tuberculosis, and malignancy. Computed tomography angiography is an accurate imaging modality for assessment of hemoptysis. The bronchial arteries are the source of bleeding in most cases of hemoptysis, and bronchial artery embolization is the treatment of choice. The aim of this article is to summarize the pathophysiology, causes, initial management, and diagnostic approach of hemoptysis. Endovascular treatment of hemoptysis, technique, embolic materials, outcomes, complications, and follow-up of patients are discussed.
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12
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Subramani S, Diaz-Parlet J. Aortic valve replacement complicated by bronchial artery hemorrhage. J Cardiothorac Vasc Anesth 2014; 29:735-7. [PMID: 24525163 DOI: 10.1053/j.jvca.2013.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Indexed: 11/11/2022]
Affiliation(s)
| | - Jay Diaz-Parlet
- Department of Anesthesiology University of Iowa, Iowa City, IA
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13
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Pourdowlat G, Varasteravan H, Kashani BS, Bagheri A. A 58-year-old woman with recurrent hemoptysis after successful bronchial artery embolization. TANAFFOS 2014; 13:57-60. [PMID: 25191496 PMCID: PMC4153271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 12/26/2013] [Indexed: 11/18/2022]
Abstract
Massive hemoptysis is a life-threatening complication of respiratory disease. It is an emergency requiring immediate medical attention. A 58 year-old woman with bronchiectasis was admitted to the hospital following episodes of massive hemoptysis. Chest CT scan and bronchoscopy did not reveal any endobronchial lesion and bronchial artery angiography and embolization were performed successfully. Despite successful embolization, her hemoptysis recurred and the patient underwent angiography for the 2(nd) time; which showed normal left bronchial artery and occluded right intercostobronchial artery. Lower thoracic aortogram revealed a systemic non-bronchial artery in the right lower lung field and evidence of pulmonary shunting. Super-selective angiogram of this artery showed vascularity to lower esophagus and considerable supply of the right lower lung field with pulmonary vascular shunting. Embolization of this non-bronchial systemic artery was carried out successfully with complete occlusion. Few days after the embolization, the patient reported pleuritic and epigastric pain and also complained of odynophagia and dysphagia; which were managed conservatively. Four days later, her symptoms improved and she was discharged subsequently. At 40-day follow up, she was still symptom-free with no hemoptysis.
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Affiliation(s)
- Guitti Pourdowlat
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran-Iran
| | - Hamidreza Varasteravan
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran-Iran
| | - Babak Sharif Kashani
- Lung Transplantation Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran-Iran
| | - Alireza Bagheri
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran-Iran
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Brown AC, Ray CE. Anterior Spinal Cord Infarction following Bronchial Artery Embolization. Semin Intervent Radiol 2013; 29:241-4. [PMID: 23997419 DOI: 10.1055/s-0032-1326936] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Anthony C Brown
- Department of Radiology, University of Colorado, Aurora, Colorado
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Proximal interruption of the pulmonary artery: Transcatheter embolization for emergent management of massive hemoptysis. Radiol Case Rep 2013; 8:865. [PMID: 27330642 PMCID: PMC4900122 DOI: 10.2484/rcr.v8i3.865] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Transcatheter embolization is the first-line treatment for massive hemoptysis and recurrent intractable hemoptysis. Proximal interruption of the pulmonary artery is a rare congenital anomaly characterized by hypertrophy and neovasculsarity of bronchial and nonbronchial aortopulmonary collaterals; hemoptysis complicates a minority of cases. We present a case of unilateral proximal interruption of the left pulmonary artery associated with a right-sided aorta, presenting in adulthood with hemoptysis. The patient was managed emergently with bronchial, intercostal, and inferior phrenic artery embolization.
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Moon JY, Lee YS, Lyu J, Huh JW, Hong SB, Kim SW, Lim CM, Koh Y. Massive Hemoptysis Cases Intubated with the Univent® Bronchial Blocker for Lung Protection. Tuberc Respir Dis (Seoul) 2012. [DOI: 10.4046/trd.2012.72.2.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Jae Young Moon
- Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Seok Lee
- Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jiwon Lyu
- Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Won Huh
- Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Bum Hong
- Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-We Kim
- Department of Internal Medicine, Division of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chae-Man Lim
- Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - YounSuck Koh
- Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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