Bronchial Artery Embolisation for Acute Massive Haemoptysis: Retrospective Study

LF Cheng, EPY Fung, TYW Hon, TKL Loke, SS Lo, JCS Chan

Hong Kong J Radiol 2005;8:15-9

Objective: To assess the efficacy and safety of bronchial artery embolisation in the treatment of acute massive haemoptysis.

Patients and Methods: Records of 34 consecutive patients (28 males and 6 females) who presented to the United Christian Hospital from June 2000 to July 2003 with acute massive haemoptysis and who underwent a total of 47 bronchial artery embolisation procedures were retrospectively studied. The following data were analysed: age, sex, aetiology, computed tomograms of the thorax, bronchial angiographic findings, embolisation results, complications related to bronchial artery embolisation, and clinical outcome during follow-up.

Results: The aetiology included previous pulmonary tuberculosis in 18 (53%) cases, previous tuberculosis with bronchiectasis in 7 (21%) cases, bronchiectasis in 6 (18%) cases, and active pulmonary tuberculosis in 1 (3%) case. No identifiable cause could be detected in 2 (6%) patients. Computed tomography of the thorax was not helpful in locating the site of bleeding in 9 (26%) patients. Massive haemoptysis was successfully controlled immediately after the embolisation procedure in 33 (97%) of 34 patients. Procedures were repeated in 7 (21%) patients because of recurrent symptoms. Three (9%) patients developed recurrent haemoptysis during the month after the procedure and were treated by re-embolisation. In addition, 3 (9%) cases developed repeated haemoptysis within 6 months of the procedure and required further embolisation. The 1-month and 6- month nonrecurrent rates were 91% (31/34) and 82% (28/34), respectively. No major procedure-related complication such as bronchial infarction was identified. No patient experienced any neurological complications.

Conclusion: Bronchial artery embolisation is a safe and effective means of controlling massive haemoptysis and should be regarded as the first-line treatment for this condition.