TRATAMIENTO ENDOVASCULAR CON EMBOLIZACIÓN BRONQUIAL EN PACIENTES CON HEMOPTISIS MASIVA

Abstract

Background: Massive hemoptysis is a medical emergency with high mortality.

Objective: The bronchial artery embolization has been proven to be an effective and safe method for its control. Our country there is little experience. We present our experience with bronchial artery embolization for initial treatment of massive hemoptysis in order to demonstrate its effectiveness and safety.

Population: Between 2001-2011 patients with massive hemoptysis requiring embolization were prospectively included. Demographic, clinical and angiographic variables were recorded.

Method: Bronchial angiography was performed in all cases. The embolization was performed under fluoroscopic control with microparticules or microspheres between 350-700 microns. The procedure was finished once the vascular beds involved were occluded. There were 59 patients included, average age 51 years (r: 2-83), woman 29. The indica- tion was massive hemoptysis (n= 22) or persistent hemoptysis (n = 37). We performed 70 embolization procedures (n = 52 single intervention and n = 7 patient required a more than one procedure). The most common sign were arterial hyper- trophy and hyper vascularity. Arteries that were considered originators of bleeding were occluded.

Results: In 57/59 there was immediate clinical success in 2/59 was required a second embolization. At follow up no recurrence was observed in 52/59 patients.

Conclusions: In this communication, the bronchial artery embolization has proven to be an excellent therapy for massive hemoptysis. Not only immediate but also to recurrence. Conducted by an experienced medical team is a safe and effective, in our institution is the initial therapeutic method of choice.