Bronchial Artery Embolization in Management of Hemoptysis in a Developing Country: An Initial Experience

P. Garg, Ayush Khandelwal, Krishna Bhardwaj, P. Ish, Rajat Khurana, A. Malik
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Abstract

Abstract Objectives  This article evaluates the immediate success, recurrence rate, complications, and the culprit vessel of bronchial artery embolization (BAE) in patients presenting with hemoptysis. Materials and Methods  All patients who underwent BAE from July 1, 2018 to August 31, 2021 were included. BAE was done for moderate to severe hemoptysis or for mild hemoptysis which was recurrent and not controlled by medical management. Patients referred for surgical intervention and hemoptysis controlled on medical management were excluded. Results  One hundred and thirty patients underwent BAE in the study period. Mean age was 41.5 years and majority (73.1%) was male. Forty-three (33.1%) patients had mild, 46 (35.4%) had moderate, and 41 (31.5%) with the duration of symptoms ranging from 3 days to 25 years. Most common culprit vessel was posterior intercostal artery closely followed by the intercostobronchial artery. Hypervascularity was the most common angiographic abnormality encountered. On an average, 2.75 vessels were embolized per BAE with a wide range of 1 to 8 vessels. Hemoptysis control was seen in 96.1% patients immediately, 90.7 % at 1 month, 82.3 % at 3 months, and 66.9 % at 6 months. Overall recurrence was seen in 43 patients (33.1%). Chest pain was the most common minor side effect occurring in 77.1% cases. Conclusion  BAE is a safe and effective procedure that can be performed routinely in patients presenting with moderate to massive hemoptysis or with mild hemoptysis refractory to medical management.
发展中国家支气管动脉栓塞治疗咯血的初步经验
【摘要】目的评价支气管动脉栓塞(BAE)治疗咯血患者的直接成功率、复发率、并发症及罪魁血管。材料与方法纳入2018年7月1日至2021年8月31日所有行BAE的患者。对中重度咯血或反复发作且无法控制的轻度咯血行BAE。排除经外科手术治疗和药物控制的咯血患者。结果研究期间有130例患者接受了BAE治疗。平均年龄41.5岁,男性居多(73.1%)。43例(33.1%)为轻度,46例(35.4%)为中度,41例(31.5%)为症状持续时间为3天至25年。最常见的罪魁祸首血管是肋间后动脉,其次是肋间支气管动脉。血管增生是最常见的血管造影异常。平均每个BAE有2.75条血管栓塞,范围为1至8条血管。96.1%的患者咳血立即得到控制,1个月时90.7%,3个月时82.3%,6个月时66.9%。总复发43例(33.1%)。胸痛是最常见的轻微副作用,发生率为77.1%。结论BAE是一种安全有效的治疗方法,可用于中度至大咯血或轻度咯血难以治疗的常规治疗。
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