Bronchial Artery Embolization, an Increasingly Used Method for Hemoptysis; Treatment and Avoidance

Özet

Objectives: Hemoptysis is an alarming symptom. It may cause some severe life-threatening complications. Hypertrophic andfragile bronchial artery causes hemoptysis and occurs mostly in bronchiectasis, sarcoidosis, active or sequelae tuberculosis, aspergilloma,lung cancer or cystic fibrosis. Bronchial artery embolization is one of the angiographic methods used in diagnosis andtreatment for years performed by radiologists. Hemoptysis is used mostly in patients with hemoptysis. Using this method, surgicalmanagement with high mortality and morbidity rates can be avoided or better conditions for surgery can be provided via stoppinghemorrhage before surgery. We aim to share the experiences of our hospital about patients who underwent bronchial arteryembolization and compare our results with the literature.Methods: Thirty-nine patients (29 male, 10 female) underwent angiography-aiming embolization. Pathologies were hemoptysis in37 patients, Castleman disease in two patients. Embolization was performed in 33 patients; 31 for hemoptysis, two for Castlemandisease. Bilateral embolization was performed in six patients.Results: Computed tomography (CT) was helpful in diagnosing the side of bleeding in 91.8% of the patients with hemoptysis.Bronchoscopy was diagnostic in 53% of patients. Polyvinyl alcohol (n=27) was mostly used for embolization. Hemoptysis recurredin six patients (19.3%). All were managed successfully, of four with re-embolization. One major complication, transient blindness,was observed.Conclusion: Bronchial artery embolization is minimally invasive, more tolerable compared to surgery can be managed with highsuccess and lower complication rates, especially hemoptysis and in some other situations. It provides time for evaluating the underlyingdisease and delaying surgery for elective conditions. That is why this method has been used increasingly.