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The role of endovascular treatment for massive hemoptysis

SUMMARY

Objectives: To assess the safety and effectiveness of arterial embolization in patients with massive hemoptysis.

Subjects and Method: All patients were diagnosed massive hemoptysis and treated endovascular intervention in Cho Ray Hospital from January 2016 to March 2017. Some variants were asscessed: etiologies, important angiographics findings, the clinical success, complications and follow-up outcomes within 1 month.

Results: 35 patients were treated by endovascular intervention. Massive hemoptysis was caused by bronchiectasis (37,1%), pulmonary tuberculosis (20%), pulmonary aspergilloma 14.3%). A total of 69 bleeding arteries were found, an average of four arteries per patient. Important angiographics findings were: vascular hypertrophy and tortuosity (80,0%), neovascularity and hypervascularity (85,7%), shunting (25,7%), aneurysm formation (8,5%) and active extravasation (5,7%). Immediate clinical success achieved was 97,1% (34/35 patients) and 11,7% of patients had recurrent over 1 month; aspergilloma and shunting were asociated with early recurrent (p<0,05). No serve complications were reported and the most common complication was trasient chest pain (28,6%).

Conclusion: Endovascular treament is an effective and safe procedure in the management of massive hemoptysis.

Keywords: massive hemoptysis, embolized arteries, clinical success, early recurrent.