Hemoptysis recurrence after successful embolization of bronchial arteries
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 5
Abstract
<b>Aim.</b> The purpose of this study is evaluation of the occurence and causes of recurrent hemoptysis after its treatment with endovascular embolization.<br><b>Materials and methods. </b>During the last decade 360 patients with severe hemoptysis were treated with embolization. Hemoptysis had many different underlying pathologies of which the most common were tuberculosis, bronchiectasis and aspergillosis. Embolization procedures were performed using different embolic materials like: absorbable haemostatic gelatin sponge (Spongostan), embolic particles (PVA – polyvinyl alcohol particles, Embospheres 350-900 μm), platinum coils and liquid materials (histoacrylate and Lipidol mixture).<br><b>Results.</b> Control of hemoptysis was achieved in 92% of patients. Over 90% of patients suffered from postembolization syndrome. No severe complications were observed. Patients in whom more than 3 neighboring intercostal arteries were embolized had intercostal muscle pain for up to two weeks. Five patients suffered transient dysphagia and four had a hoarse throat. Bleeding recurrence was noted in 33% of cases within 12 months. The highest rate of recurrences occurred in patients with tuberculosis and aspergillosis and was due to revascularization by collaterals. Out of 99 patients with recurrent hemoptysis 72 underwent second embolization. Collaterals developed mainly from intercostal arteries.<br><b>Conclusions. </b>Late recurrent bleeding after treatment of massive hemoptysis with embolization was observed in 33% of cases, most commonly in patients with tuberculosis and aspergillosis, as a result of revascularization of pathological lesions through local collateral circulation. To a lesser degree, recurrent bleedings were caused by incomplete occlusion of pathological vasculature.
Authors and Affiliations
Michał Przyszlak, Tomasz Jargiełło, Monika Miazga, Anna Drelich-Zbroja, Małgorzata Szczerbo-Trojanowska
Keywords
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