Bronchial artery embolization procedure demonstrated effectiveness and safety to treat hemoptysis in chronic thromboembolic pulmonary hypertension patients at our center, but further controlled studies are needed before it can be considered as an effective therapy for these patients Angiography of the systemic and pulmonary arteries revealed the vessel responsible for the recurrent hemoptysis and pulmonary artery embolization was successfully performed. It is essential to identify the culprit vessel and physicians must not hesitate in performing embolization when patients develop lethal hemoptysis. PMCID: PMC579071 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
In conclusion, embolization via the pulmonary artery is an alternative endovascular procedure for the management of hemoptysis in patients in whom bronchial or nonbronchial systemic artery embolization is not possible Bronchial artery embolization is the treatment of choice for the management of life-threatening massive hemoptysis. Chronic pulmonary thromboembolism (PTE) is one of the rare causes of hemoptysis. Management of hemoptysis in chronic PTE is a point of debate Hemoptysis frequently develops in patients with Mycobacterium avium complex (MAC) pulmonary disease. Bronchial artery embolization (BAE) has been established as one of the useful treatments of massive and persistent hemoptysis
Purpose: To evaluate the clinical outcomes of bronchial artery embolization (BAE) using a gelatin sponge for hemoptysis from pulmonary aspergilloma and compare them with treatment outcomes for hemoptysis from other diseases. Methods: Fifty-two patients underwent BAE using a gelatin sponge. The etiology of hemoptysis was pulmonary aspergilloma in 8 (PA group) and other diseases in 44 (control. Bronchial artery embolization (BAE) is one of the treatment options for hemoptysis. We reviewed the 10-yr experience at the University of North Carolina Hospitals in the treatment of hemoptysis by BAE. Eighteen patients with CF were hospitalized on 29 occasions and underwent 36 BAE procedures for the control of hemoptysis A 28-year-old man with a history of coil embolization of multiple pulmonary arteriovenous malformations presented with hemoptysis 11 years after initial embolization. A cavity lesion in the left upper lobe, which was accompanied by deformed coils and ground-glass opacity, was considered responsible for hemoptysis Introduction. Percutaneous catheter-based treatment for hemoptysis of the bronchial and pulmonary arteries and transcatheter embolization of pulmonary arteriovenous malformations, aneurysms, and pseudoaneurysms were first reported in the 1970s (, 1).When adequate vascular catheters, guide-wires, and snare loops became available, percutaneous foreign body retrieval from the heart or pulmonary. Lung metastasis is a rare cause of hemoptysis. Bronchial artery embolization is an effective intervention for treatment of hemoptysis with various underlying etiologies. A 28-year-old man with a known history of malignant melanoma in the neck from 6 years ago and lung metastasis from 1 year ago referred to the Emergency Department of our teaching hospital with the chief complaint of hemoptysis...
Patients with ES-PAH are at increased risk of pulmonary artery thrombosis with concurrent increased risk of hemoptysis and pulmonary hemorrhage (1). Thrombo-embolic risks include atrial fibrillation and indwelling central catheters. Hemoptysis is often due to bronchial artery dilatation and/or rupture Pulmonary artery pseudoaneurysm is an extremely rare cause of hemoptysis. This case will raise awareness to recognize this disease and consult interventional radiology for embolization emergently
Embolization with polyvinyl alcohol particles (350-500 μm) was successfully performed, and this patient showed complete resolution of hemoptysis after bronchial artery embolization. Clinical success was achieved in 69 patients (82.1%): complete clinical success in 53 (63.1%) patients and partial clinical success in 16 (19.0%) patients Inclusion criteria were: patients with lung cancer and at least 1 episode of hemoptysis with a pulmonary artery lesion detected by computed tomography (CT) angiography or after failed bronchial artery embolization. No patient undergoing pulmonary embolization for a lung tumor was excluded The anatomic source of bleeding in hemoptysis may either be from the pulmonary arteries, which account for approximately 99% of the blood supply to the lungs, or the bronchial arteries which account for approximately 1% (15)
Pulmonary artery lesions may be responsible for hemoptysis in patients with lung cancer and should be considered based on CT angiography findings or in those patients with persistent bleeding after bronchial artery embolization PURPOSE: To determine the efficacy of bronchial artery embolization in the control of massive hemoptysis due to pulmonary tuberculosis. MATERIALS AND METHODS: Between 1988 and 1994, 140 patients (125 men and 15 women; mean age, 31.5 years) who presented with massive hemoptysis (more than 300 mL of blood in 24 hours) underwent bronchial artery embolization THE DEFINITION of massive hemoptysis and the incidence of cancer as a cause for pulmonary bleeding have ranged widely ().Pulmonary resection to treat massive hemoptysis has been associated with the best results, but postoperative death rates have been about 40% when operations were undertaken as emergencies ().In relatively recent years, therapeutic bronchial artery embolization (TBAE) has.
. We herein describe the case of 19-year-old woman with ES caused by patent ductus arteriosus (PDA) in whom recurrent lethal hemoptysis was success-fully treated by pulmonary artery embolization. Case Descriptio Massive hemoptysis due to pulmonary tuberculosis: control with bronchial artery embolization. Radiology 1996; 200:691-694. Link, Google Scholar; 13 Mal H, Rullon I, Mellot F, et al. Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Chest 1999; 115:996-1001. Crossref, Medline, Google Schola Bronchial artery embolization is not indicated in the uncommon case in which hemoptysis arises from a nonbronchial source (systemic collateral artery or pulmonary artery). If there is concern that nontarget embolization may occur, especially to the spinal cord, leading to permanent neurologic deficit, embolization should be deferred
Control of massive hemoptysis by embolization of bronchial arteries was achieved in two patients with bronchopleural fistula. Both patients would have been prohibitive risks for thoracotomy. The indications, contraindications, and technique of the procedure are presented as well as a review of the literature Bronchial artery embolization is an effective intervention for treatment of hemoptysis with various underlying etiologies. A 28-year-old man with a known history of malignant melanoma in the neck from 6 years ago and lung metastasis from 1 year ago referred to the Emergency Department of our teaching hospital with the chief complaint of hemoptysis Hemoptysis is a recognized complication of pulmonary arterial hypertension (PAH), although its exact incidence is not known.1, 2 The ideal management of hemoptysis in patients with PAH remains uncertain. Embolization of bronchial arteries has been proposed as an effective means of treating patients with recurrent hemoptysis secondary to PAH.2, 3 Case Descriptio Mal H, Rullon I, Mellot F, et al. Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Chest 1999;115:996-1001. Ramakantan R, Bandekar VG, Gandhi MS, et al. Massive hemoptysis due to pulmonary tuberculosis: control with bronchial artery embolization. Radiology 1996;200:691-4
Introduction. Bronchial artery embolization (BAE) has been accepted as the most effective minimally invasive therapy alternative to surgery for massive and recurrent hemoptysis (1,2).However, because BAE does not address the underlying disease, recurrence of hemoptysis is common and requires frequent repeat embolization ().Although advances in embolic materials and embolization techniques have. To determine the effectiveness of endovascular embolization as a temporizing measure in the management of severe hemoptysis caused by intracavitary pulmonary aspergilloma. Patients presenting with hemoptysis, estimated to be more than 300 ml in the preceding 24 hr, in whom a radiological diagnosis of pulmonary aspergilloma was made on chest radiographs and/or computed tomography of the chest. EMBOLIZATION FOR HEMOPTYSIS Fig. 2. A 58-year-old man with silicosis in whom bronchoscopy revealed a blood clot in the right upper lobe bronchus. Embolothera- py was divided in two sessions. In the first session, embolization of the right bronchial artery was performed. In the second session, the internal mammary artery was embolized Embolization for Hemoptysis in Chronic Thromboembolic Pulmonary Hypertension: Report of Two Cases and a Review of the Literatur
, MD, J erome Soussan, MD, Florian Desmots, MD We describe a percutaneous procedure for pulmonary segmental artery embolization. Between May 2000 and July 2006, 27 adult patients with hemoptysis underwent percutaneous treatment at our department; 20 of 27 patients were embolized via bronchial and or nonbronchial systemic arteries and 7 patients were embolized via pulmonary artery Background. Bronchial artery embolization (BAE) is widely used for the treatment of hemoptysis. The immediate and long-term results of BAE for hemoptysis in patients with benign and malignant pulmonary diseases were inconsistent in previous studies and were thus investigated Systemic-to-pulmonary collateral vessels and shunts develop in patients with isolated unilateral absence of a pulmonary artery (IUAPA). Two cases of IUAPA (right and left) with hemoptysis in adult life are presented. Selective embolization of these systemic vessels controlled hemoptysis successfully. These cases represent an example of an alternative treatment for this rare anomaly Purpose of study: Hemoptysis is a common emergency coming to the pulmonary medicine and general Medicine department.Massive hemoptysis has high mortality even after surgical treatment. Bronchial artery embolization is an effective alternative to surgery for controlling hemoptysis, with high success rate
INTRODUCTION. Hemoptysis is defined as expectoration of blood originating from the tracheobronchial tree or pulmonary parenchyma. Although hemoptysis is not dangerous, about 5-15% can be life-threatening, with mortality rate more than 50% if managed inappropriately .Since its introduction by Remy et al.  as an alternative to surgery, bronchial artery embolization (BAE) has established. Two case reports of bronchial artery pseudoaneurysm causing massive hemoptysis have been described in HIES patients, both of which were managed with bronchial artery embolization [4, 5]. As of the date of publication, this is the first case reported in the literature of pulmonary artery pseudoaneurysm causing massive hemoptysis in a patient. That pulmonary artery pseudoaneurysms are a potent cause of bleeding and require treatment is supported by the fact that in three patients in whom bronchial artery embolization alone was initially performed (patients 2, 3, and 4), hemoptysis continued until the pseudoaneurysms were occluded via a pulmonary artery approach
Chest pain was experienced following embolization in 7% of patients. The mortality was 10% due to the inclusion of patients with pulmonary metastases. Bronchial artery embolization using microspheres is an effective and well-tolerated treatment for patients with life-threatening hemoptysis who are not surgical candidates Here, we are presenting our experience of bronchial artery embolization in 11 patients presented in outpatient department with massive hemoptysis. Material and Methods . In our hospital-based cross-sectional study, 11 patients had undergone procedure for bronchial artery embolization in the Department of Interventional Radiology (TIFAC-CORE) 3. Discussion. Inflammatory pulmonary artery aneurysms are an extremely uncommon cause of hemoptysis in pulmonary tuberculosis. Far more commonly, hemorrhage occurs from hypertrophied bronchial arteries .Fritz Waldemar Rasmussen, a Danish physician, first described 11 cases of pulmonary aneurysms in patients with tuberculosis in 1868 .Auerbach in 1939 detected pulmonary aneurysms in 4% of. B, Selective digital subtraction angiography image demonstrates hypertrophy in the right intercostobronchial trunk (arrow head) with systemic-pulmonary shunting (arrow). C, Superselective catheterization of the right bronchial artery with a 1.9 Fr microcatheter. Immediate cessation of hemoptysis was obtained after embolization of this artery. The most common angiographic sign for hemoptysis was hypervascularity (98%), followed by systemic-pulmonary artery shunt (34.5%), while pulmonary artery aneurysms represented the least common finding (2%) and were found exclusively in patients with Behcet's disease (Table 2).It was noticed that all cases with systemic-pulmonary shunt showed a sharp cutdown of the pulmonary arterial blood.
Left bronchial artery. Inter-costo bronchial trunk Chronic pulmonary tuberculosis. 15 Post-Embolization angiogram. 16 Post-embolization angiogram. Left upper lobe lung cancer. 17 (No Transcript) 18 Pseudoaneurysm of right pulmonary artery Post lung CA resection. 19 (No Transcript) 20 Post-embolization angiogram. 21 Management of Hemoptysis Pulmonary artery pseudoaneurysm is a rare but fatal condition. It has been associated with lung cancer, abscesses, and radiation therapy. Identification in patients with hemoptysis is critical, and timely interventional therapy is warranted. KEYWORDS hemoptysis, lung cancer, pulmonary artery pseudoaneurysm, radiatio Behcet's disease (BD) is a rare autoimmune disorder that results in diffuse full-thickness vasculitis. Pulmonary artery aneurysms (PAAs) and hemoptysis are known complications of this disease process, with high morbidity and mortality for affected patients. Although medical, endovascular, and surgical treatment strategies have all been described in the literature, there are little data to. Previous studies suggest that recurrence of hemoptysis after arterial embolization is associated with the underlying pulmonary disease. Purpose To compare the baseline information and imaging findings in patients with hemoptysis due to either chronic pulmonary tuberculosis (PTB) or bronchiectasis and to identify predictors of rebleeding after. Conclusion: The internal mammary artery contributes to the perfusion of lesions responsible for hemoptysis when the basic lesion involves the pulmonary parenchyma adjacent to the anterior pleural surface. Initial distal occlusion of the internal mammary artery may improve the efficacy of embolization of this artery for hemoptysis
Embolization via bronchial artery angiography is becoming the preferred method with which to stop massive hemoptysis, with reported success rates of up to 90% . Emergency surgery is indicated for massive hemoptysis not controlled by rigid bronchoscopy or embolization and is generally considered a last resort Treatment options for recurrent hemoptysis and definitive management are discussed, highlighting the role of bronchial artery embolization for recurrent hemoptysis. It is estimated that 5-14% of patients presenting with hemoptysis will have life-threatening hemoptysis, with a reported mortality rate between 9 and 38% 1408 Mehta et al. Bronchial artery embolization for malignant hemoptysis Journal of Thoracic Disease. All rights resere. www.thoracis.com J Thorac Dis 2015;7(8):1406-1413 imaging studies were reviewed when available. Arterial access into the right or left common femoral artery was obtained using a micropuncture set (Cook, Bloomington, IN, USA)
The left phrenic artery was embolized, but hemoptysis recurred. A second arteriogram revealed communication between the left mammary artery and some intercostal branches with the pulmonary circulation a and b, and embolization was repeated. Thereafter hemoptysis changed to a blood stained bronchorrhea Bronchial artery embolization (BAE) is a procedure that is used to treat severe, ongoing, or recurrent vomiting of blood (hemoptysis).Hemoptysis can be caused by pneumonia, bronchitis, lung cancer, tuberculosis, brochiectasis, and pulmonary thromboembolism A case of massive hemoptysis due to pulmonary sequestration is presented. Initially, the diagnosis of sequestration was unsuspected and bronchial artery embolization was done for management of hemoptysis from the left lower lobe, but 4 days later massive hemoptysis recurred. Repeat arteriography, including a thoracoabdominal aortogram, revealed two large abdominal arteries penetrating the left. monary artery embolization in a patient suffering from hem-optysis post TEVAR, although our treatment plan ultimately failed. In the present case, hemoptysis was temporarily con-trolled by coil embolization of a pulmonary artery branch in the upper lobe, but the patient died of a recurred hemoptysis 40days thereafter Some cases of pulmonary actinomycosis occasionally present with massive or recurrent hemoptysis and were treated with bronchial artery embolization (BAE) or thoracotomy in order to control bleeding (3,6)
chial artery embolization (BAE) for the treatment of hemop-tysis in ES (2, 3), there have been no reports on pulmonary artery embolization. We herein describe the case of 19-year-old woman with ES caused by patent ductus arteriosus (PDA) in whom recurrent lethal hemoptysis was success-fully treated by pulmonary artery embolization. Case Repor opacity, was considered responsible for hemoptysis. Embolization of the bronchial artery was performed. 1. Introduction Pulmonary arteriovenous malformations (PAVMs) are abnormal communications between the pulmonary arteries and veins without any intervening capillary beds, which cause hypoxemia, cyanosis, and dyspnea . šey are o‡en associ According to a study of Agmy et al. from Egypt, which included 341 patients with moderate to severe hemoptysis who underwent bronchial artery embolization, TB (either active or sequelae) was the most common etiology of hemoptysis with an incidence of 57%, followed by bronchiectasis (22%) and aspergilloma (8%)
During the study period, we treated 320 patients for hemoptysis of systemic artery origin and 27 patients for hemoptysis of pulmonary artery origin, 12 (44.4%) of them with ethylene vinyl alcohol copolymer. In these 12 patients, the underlying diseases were necrotizing pneumonia in four patients, necrotizing aspergillosis in one patient. Bronchial artery embolization for life-threatening hemoptysis is a well-established endovascular procedure to reduce or stop hemorrhage in patients with pulmonary inflammatory disease who are unsuitable for surgical resection .Different embolic materials have been used, from gelfoam powder to polyvinyl alcohol particles (PVA), to embolize bleeding bronchial arteries, with initial technical.
We systematically reviewed the role of bronchial artery embolization (BAE) in hemoptysis. Literature search was done for studies on BAE published between 1976 and 2016. Twenty-two studies published in English, with sample size of at least 50 patients, reporting indications, technique, efficacy, and follow-up were included in the final analysis Hemoptysis is a common emergency coming to the pulmonary medicine and . general Medicine department. Massive hemoptysis has high mortality even after surgical treatment. Bronchial artery embolization is an effective alternative to surgery for controlling hemoptysis, with high success rate. Material and methods Pulmonary hemorrhage, also referred to as massive hemoptysis, is a potentially life-threatening condition involving bleeding from the pulmonary or bronchial vasculature which is usually due to higher pressure of the bronchial system. In cases where bronchial artery embolization has not yet been performed, mortality approaches 70 percent Hemoptysis constitutes a common and urgent medical problem. Swift and effective management is of crucial importance, especially in severe, life-threatening cases. In cases of idiopathic hemoptysis, in which no underlying pulmonary pathology can be identified, treatment is challenging. We report our experience with bronchial artery embolization in the treatment of massive idiopathic hemoptysis
Hemoptysis, which can be life threatening, complicates the course of 50% to 85% of patients with an aspergilloma. 21 Tuberculosis can cause massive hemoptysis through multiple mechanisms: active cavitary or noncavitary lung disease can cause small or large amounts of bleeding. Active disease can cause sudden rupture of a Rasmussen aneurysm (aneurysm of the pulmonary artery that slowly expands. a peripheral pulmonary artery pseudoaneu-rysm may occasionally develop and be the source of massive bleeding. The incidence of pulmonary artery pseudoaneurysmal disease as a cause of massive hemoptysis is unclear. The aim of this study was to review records and histories of patien ts referred for bronchial embolization in whom a pulmonary artery
Terminology. Massive hemoptysis is referred to as expectoration of >100-600 mL of blood over a 24 hour period 6.. Pathology. In 90% of cases, the source of bleeding is the bronchial artery.In the remainder of cases, either the pulmonary artery or another non-bronchial artery (e.g. intercostal, internal thoracic) is the source of bleeding.. Etiology. The following are the most common causes Key Words: chronic thromboembolic pulmonary hypertension; bronchial artery embolization; hemoptysis C hronic thromboembolic pulmonary hypertension (CTEPH), caused by pulmonary vascular throm-boembolism and subsequent wall remodeling and hypertrophy, is a serious life-threatening disease (1-3). Du An arteriovenous shunt is observed with left pulmonary d) Selective catheterization of the left internal mammary artery shows the anomalous vascularization in the periphery of the cavern. A nodular image compatible with a Rasmussen aneurysm is observed. e) Post embolization result with 300-500 and 700-900 micres of trysacaryl Chen J, Chen LA, Liang ZX, et al. Immediate and long-term results of bronchial artery embolization for hemoptysis due to benign versus malignant pulmonary diseases. Am J Med Sci 2014; 348:204. Fernando HC, Stein M, Benfield JR, Link DP. Role of bronchial artery embolization in the management of hemoptysis. Arch Surg 1998; 133:862. Sellars N.
An acute pneumonia associated with moderate to massive hemoptysis raises the possibility of mycotic aneurysm; pulmonary arteriography is indicated, which allows for diagnosis and treatment during the same study. Successful embolization may obviate the need for surgery or convert an emergency thoracotomy to an elective procedure The bronchial-pulmonary artery fistula can cause lethal hemoptysis, therefore, we performed thoracic endovascular aortic repair (TEVAR) to seal the bronchial artery and coil embolization of the pulmonary artery. Postoperative CT showed the thrombosed racemose hemangioma of the bronchial artery The criteria for embolization follow those set by the Cystic Fibrosis Consensus Committee on Pulmonary Complications of Cystic Fibrosis, and those of Cohen and colleagues : (1) major hemoptysis as previously defined, (2) mild or chronic hemoptysis that interferes with lifestyle, and (3) hemoptysis that interferes significantly with airway. Only 5% of hemoptysis is attributable to the pulmonary arteries, which have a pressure that is a fifth of systemic, but infectious and inflammatory pulmonary artery pseudoaneurysms are a common.
A 42-year-old man presented with a 10-year history of occasional self-limiting small-volume hemoptysis. His physical examination, routine laboratory tests, and bronchoscopy were unremarkable. An echocardiogram showed no other cardiac defects and a normal resting systolic pulmonary artery pressure (25 mm Hg) The aim of this article is to summarize the etiologies, pathophysiology, and the diagnostic and management strategies of hemoptysis as related to bronchial artery embolization. In addition, the techniques of arteriography and embolization as well as associated procedural outcomes and complications are delineated
artery embolization (BAE) may provide an effective means of rapid diagnosis and treatment of such medical emergencies [2,3,5]. BAE is a well-established, non-surgical procedure in the treatment of hemoptysis [3,5,6]. BAE has emerged in recent years as a treatment for severe, life-threatening hemoptysis, and has revolutionized the management o Commentary on Bronchial Artery Embolization for Hemoptysis in Young Patients with Cystic Fibrosis [letter] Stanko Yovichevich , MD PO Box 9, Marrickville 1475, Sydney, New South Wales, Australia e-mail: email@example.com Editor: I read with great interest the article by Dr Barben and colleagues in the July 2002 issue of Radiology ( 1 ) Bronchial artery embolization has proven to be a safe and effective method of controlling recurrent or massive hemoptysis due to a variety of inflammatory and/or neoplastic processes. We recently had an opportunity to use superselective embolization to successfully treat a patient with hemoptysis from pulmonary metastases, the first such.
Bronchial varix is a rare pulmonary disorder which may lead to life-threatening hemorrhage. Diagnosis is difficult because of the subtle abnormalities on radiographic and bronchoscopic examination. We present a case of massive hemoptysis from a bleeding bronchial varix. In the absence of immediate complex endobronchial therapy in the island of Guam, this case was initially managed with. Pulmonary artery pseudoaneurysm (PAP) is a rare complication of septic pneumonia. It is potentially fatal because of the risk of massive hemoptysis. Treatment of PAP involving massive hemoptysis is by embolization or surgery. However, the progression of PAP after embolization has not been reported. A 59-year-old male who was recovering from septic pneumonia experienced massive hemoptysis A pulmonary artery pseudoaneurysm (PAP) is a rare and potentially life-threatening entity. It may be idiopathic or may be related to a traumatic injury to a pulmonary artery, infection, primary or metastatic lung neoplasm, pulmonary hypertension, or vasculitis. Common clinical manifestations of PAPs include cough and hemoptysis Multidetector computed tomography (MDCT) angiography is a useful examination to detect the source of the bleeding in patients with hemoptysis. The aim of the study was to prospectively evaluate the role and clinical efficacy of MDCT angiography before bronchial artery embolization (BAE) for the management of hemoptysis, and to investigate the predictors of early recurrence