Outcomes and safety of bronchial artery embolization in control of massive hemoptysis

Abstract

Abstract Background The most frequent causes of massive hemoptysis are bronchiectasis, myecetoma, tuberculosis, bronchial carcinoma, and cryptogenic hemoptysis. Objective This study aimed to investigate the outcomes, safety, and complications of bronchial artery embolization (BAE) in the management of massive hemoptysis. Patients and methods This study included 32 patients who presented with massive hemoptysis who were indicated for BAE. The following data were obtained from each patient: detailed history, clinical examination, chest radiograph, computed tomography pulmonary angiography, fiberoptic bronchoscopy, and BAE. Results Fifteen patients underwent BAE as an urgent procedure for control of massive hemoptysis and 17 patients underwent BAE as an elective procedure. The complications of BAE were fever in four patients (12.5%), back pain in three (9.38%), failure of BAE in two (6.25%), recurrence of hemoptysis in one (3.13%), and no mortality. BAE was successful in 30 out of 32 (93.75%) cases. Failure of catheterization was encountered in one (3.13%) case because of dissection during negotiations; therefore, no catheterization was performed. The second (3.13%) case showed extensive bronchial–pulmonary shunt with severe lung destruction, so that the procedure was deemed futile. After the procedure, immediate control of hemoptysis was achieved in 29 (90.62%) patients. Conclusion BAE can be used safely and effectively for control of massive hemoptysis; it can be used as an alternative nonsurgical option along with medical treatment or as a bridge to stabilize the patient until definitive surgical management can be performed. BAE can be considered an alternative to surgery if the patient is not fit for surgical intervention.

Keywords

• bronchial artery
• bronchoscopy
• embolization
• hemoptysis