Role of Bronchial Artery Embolization in the Management of Hemoptysis

Abstract

THE DEFINITION of massive hemoptysis and the incidence of cancer as a cause for pulmonary bleeding have ranged widely (Table 1). Pulmonary resection to treat massive hemoptysis has been associated with the best results, but postoperative death rates have been about 40% when operations were undertaken as emergencies (Table 2). In relatively recent years, therapeutic bronchial artery embolization (TBAE) has been added to the treatment options available for the control of hemoptysis.⁶ The rationale for TBAE is that the higher-pressured systemic pulmonary circulation (bronchial arteries) is often the source of major hemoptysis. This reasoning is based in part on evidence that inflammatory lung disease and lung cancer enhance the systemic circulation in areas of decreased pulmonary circulation and that hemoptysis occurs secondary to the rupture of systemic arteries in areas of inflamed or necrotic tissue.⁷ Recent information about the effects of TBAE on the management of hemoptysis, however, is limited. Therefore, we have evaluated the role that TBAE occupied in our treatment of hemoptysis in recent years.