BRONCHIAL ARTERIOGRAPHY AND TRANSCATHETER EMBOLIZATION IN MANAGEMENT OF SEVERE HAEMOPTYSIS.

The purpose of this study was to assess the effectiveness of bronchial arteriography and transcatheter embolization in treatment of severe haemoptysis. Forty five patients with severe haemoptysis were evaluated by means of bronchial arteriography and study of non bronchial systemic arteries and underwent transcatheter embolization. Specific causes of haemoptysis were Tuberculosis (n=37), Tuberculosis with Aspergilloma (n=4) and bronchiectasis (n=4). Gel foam pellets and polyvinyl alcohol (PVA) particles were used as embolic material in 36 patients and 9 patients respectively. The angiographic signs of haemorrhage encountered were extravasation of contrast in 2 patients (4.4%), hypervascularisation in 42 (93.3%), broncho-pulmonary shunt in 13 (28.8%) and bronchial artery aneurysm in 1 patient (2.2%). Immediate control of bleeding occurred in 44 (97.7%) of 45 patients after embolization. Recurrent haemoptysis occurred in 4 cases (11.9%) more than 1 month after embolization but bleeding was less severe, than before treatment. This study suggests that bronchial artery embolization is an effective method of managing patients with severe haemoptysis, minor bleeding recurrences appear to be relatively infrequent.