Skip to main content
The Egyptian Journal of Bronchology
Download PDF
  • Original article
  • Open access
  • Published:

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

Egyptian Journal of Bronchology volume 13, pages 666–671 (2019)Cite this article

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.

References

  1. Flume PA, Yankaskas JR, Ebeling M, Hulsey T, Clark LL. Massive hemoptysis in cystic fibrosis. Chest 2005; 128:729–738.

    Article  Google Scholar 

  2. Ibrahim WH. Massive haemoptysis: the definition should be revised. Eur Respir J 2008; 32:1131.

    Article  CAS  Google Scholar 

  3. Khalil A, Parrot A, Nedelcu C, Fartoukh M, Marsault C, Carette MF, et al. Severe hemoptysis of pulmonary arterial origin: signs and role of multidetector row CT. Chest 2008; 133:212–219.

    Article  Google Scholar 

  4. Sakr L, Dutau H. Massive hemoptysis: an update on the role of bronchoscopy in diagnosis and management. Respiration 2010; 80:38–58.

    Article  CAS  Google Scholar 

  5. Zhang Y, Chen C, Jiang GN. Surgery of massive hemoptysis in pulmonary tuberculosis: immediate and long-term outcomes. J Thorac Cardiovasc Surg 2014; 148:651–656.

    Article  Google Scholar 

  6. Seedat UF, Seedat F. Post-primary pulmonary TB haemoptysis – When there is more than meets the eye. Respir Med Case Rep 2018; 25:96–99.

    PubMed  PubMed Central  Google Scholar 

  7. Radchenko C, Alraiyes AH, Shojaee S. A systematic approach to the management of massive hemoptysis. J Thorac Dis 2017; 9:S1069–S1086.

    Article  Google Scholar 

  8. Najarian KE, Morris CS. Arterial embolization in the chest. J Thorac Imaging 1998; 13:93–104.

    Article  CAS  Google Scholar 

  9. Marshall TJ, Jackson JE. Vascular intervention in the thorax: bronchial artery embolization for haemoptysis. Eur Radiol 1998; 7:1221–1227.

    Article  Google Scholar 

  10. Khalil A, Soussan M, Mangiapan G, Fartoukh M, Parrot A, Carette MF. Utility of high-resolution chest CT scan in the emergency management of haemoptysis in the intensive care unit: severity, localization and aetiology. Br J Radiol 2007; 80:21–25.

    Article  CAS  Google Scholar 

  11. McGuinness G, Beacher JR, Harkin TJ, Garay SM, Rom WM, Naidich DP. Hemoptysis: prospective high-resolution CT/bronchoscopic correlation. Chest 1994; 105:1155–1162.

    Article  CAS  Google Scholar 

  12. Revel MP, Fournier LS, Hennebicque AS, Cuenod CA, Meyer G, Reynaud P, et al. Can CT replace bronchoscopy in the detection of the site and cause of bleeding in patients with large or massive hemoptysis. Am J Roentgenol 2002; 179:1217–1224.

    Article  Google Scholar 

  13. Ramakantan R, Bandekar VG, Gandhi MS, Aulakh BG, Deshmukh HL. Massive hemoptysis due to pulmonary tuberculosis: control with bronchial artery embolization. Radiology 1996; 200:691–694.

    Article  CAS  Google Scholar 

  14. Shigemura N, Wan IY, Yu SC, Wong RH, Hsin MK, Thung HK, et al. Multidisciplinary management of life-threatening massive hemoptysis: a 10-year experience. Ann Thorac Surg 2009; 87:849–853.

    Article  Google Scholar 

  15. Knott-Craig CJ, Oostuizen G, Rossouw G, Joubert JR, Barnard PM. Management and prognosis of massive hemoptysis: recent experience with 120 patients. J Thorac Cardiovasc Surg 1993; 105:394–397.

    Article  CAS  Google Scholar 

  16. Soares Pires F, Teixeira N, Coelho F, Damas C. Hemoptysis – etiology, evaluation and treatment in a university hospital. Rev Port Pneumol 2011; 17:7–14.

    Article  CAS  Google Scholar 

  17. Fruchter O, Schneer S, Rusanov V, Belenky A, Kramer MR. Bronchial artery embolization for massive hemoptysis: long-term follow-up. Asian Cardiovasc Thorac Ann 2015; 23:55–60.

    Article  Google Scholar 

  18. Dabo H, Gomes R, Marinho A, Madureira M, Paquete J, Morgado P. Bronchial artery embolisation in management of hemoptysis – a retrospective analysis in a tertiary university hospital. Rev Port Pneumol (2006) 2016; 22:34–38.

    Google Scholar 

  19. Tom LM, Palevsky HI, Holsclaw DS, Trerotola SO, Dagli M, Mondschein JI. Recurrent bleeding, survival, and longitudinal pulmonary function following bronchial artery embolization for hemoptysis in a U.S. adult population. J Vasc Interv Radiol 2015; 26:1806–1813.

    Article  Google Scholar 

  20. van den Heuvel MM, Els Z, Koegelenberg CF, Naidu KM, Bolliger CT, Diacon AH. Risk factors for recurrence of haemoptysis following bronchial artery embolisation for life-threatening haemoptysis. Int J Tuberc Lung Dis 2007; 11:909–914.

    PubMed  Google Scholar 

  21. Yoo DH, Yoon CJ, Kang SG, Burke CT, Lee JH, Lee CT. Bronchial and nonbronchial systemic artery embolization in patients with major hemoptysis: safety and efficacy of N-butyl cyanoacrylate. Am J Roentgenol 2011; 196:W199–W204.

    Article  Google Scholar 

  22. Swanson KL, Johnson M, Prakash UBS, McKusick MA, Andrews JC, Stanson AW. Bronchial artery embolization, experience with 54 patients. Chest 2002; 121:789–795.

    Article  Google Scholar 

  23. Bhalla A, Kandasamy D, Veedu P, Mohan A, Gamanagatti S. A retrospective analysis of 334 cases of hemoptysis treated by bronchial artery embolization. Oman Med J 2015; 30:119–128.

    Article  Google Scholar 

  24. Hsiao EI, Kirsch CM, Kagawa FT, Wehner JH, Jensen WA, Baxter RB. Utility of fiberoptic bronchoscopy before bronchial artery embolization for massive hemoptysis. Am J Roentgenol 2001; 177:861–867.

    Article  CAS  Google Scholar 

  25. Remy J, Voisin C, Ribet M, Dupuis C, Beguery P, Tonnel AB, et al. Treatment, by embolization, of severe or repeated hemoptysis associated with systemic hypervascularization. Nouv Presse Med 1973; 2:2060–2068.

    CAS  PubMed  Google Scholar 

  26. Barben J, Robertson D, Olinsky A, Ditchfield M. Bronchial artery embolization for hemoptysis in young patients with cystic fibrosis. Radiology 2002; 224:124–130.

    Article  Google Scholar 

  27. Fartoukh M, Khalil A, Louis L, Carette MF, Bazelly B, Cadranel J, et al. An integrated approach to diagnosis and management of severe haemoptysis in patients admitted to the intensive care unit: a case series from a referral centre. Respir Res 2007; 8:11.

    Article  Google Scholar 

  28. Garcia-Olive I, Sanz-Santos J, Centeno C, Andreo F, Munoz-Ferrer A, Serra P, et al. Results of bronchial artery embolization for the treatment of hemoptysis caused by neoplasm. J Vasc Interv Radiol 2014; 25:221–228.

    Article  Google Scholar 

  29. Cremaschi P, Nascimbene C, Vitulo P, Catanese C, Rota L, Barazzoni GC, et al. Therapeutic embolization of bronchial artery: a successful treatment in 209 cases of relapse hemoptysis, ‘. Angiology 1993; 44:295–299.

    Article  CAS  Google Scholar 

  30. Pollak J. Radiologic management of massive hemoptysis. Contemp Intern Med 1998; 10:28–35.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Chest Diseases, Faculty of Medicine, Tanta University, Tanta, 31111, Egypt

    Gehan H. AboEl-Magd MD (Assistant Professor of Chest Diseases)

  2. Radiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Ahmad H. Abouissa & Mohamed M. Harraz

  3. Chest Department, Al-Noor Specialist Hospital, Makkah, Saudi Arabia

    Gehan H. AboEl-Magd MD (Assistant Professor of Chest Diseases)

  4. Interventional Radiology Department, Al-Noor Specialist Hospital, Makkah, Saudi Arabia

    Ahmad H. Abouissa

Authors
  1. Gehan H. AboEl-Magd MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ahmad H. Abouissa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohamed M. Harraz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gehan H. AboEl-Magd MD.

Additional information

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

AboEl-Magd, G.H., Abouissa, A.H. & Harraz, M.M. Outcomes and safety of bronchial artery embolization in control of massive hemoptysis. Egypt J Bronchol 13, 666–671 (2019). https://doi.org/10.4103/ejb.ejb_51_19

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ejb.ejb_51_19

Keywords