[Bronchial artery embolization for therapy of pulmonary bleeding in patients with cystic fibrosis]

A Thalhammer, V Jacobi, J Balzer, R Straub, T J Vogl
RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin 2002, 174 (5): 588-92

INTRODUCTION: Acute pulmonary emergencies in patient with cystic fibrosis (CF) can be found in cases of pneumothorax as well as hemoptysis. If the bleeding cannot be stopped by conservative methods, an embolization of the bronchial arteries should be done.

MATERIALS AND METHOD: 11 patients were embolized using a combination of PVA particles and microcoils.

RESULTS: From January 1996 to June 2001 17 bronchial arteries in 11 patients were embolized. 7 patients suffered from chronical hemoptysis, 4 patients had an acute hemoptysis. In 4 patients both sides were embolized, in 3 patients only one side. The remaining 4 patients needed a second intervention, embolizing the other side. The primary embolizated bronchial artery was still closed in all 4 patients. In 1 patient the selective catheterization of a bronchial artery was not successful, thus the embolization could not be carried out. 1 patient died 5 days after the intervention due to a fulminant pneumonia (Pseudomonas aeruginosa) without recurrent bleeding. In two patients atypical branches from intercostal arteries feeding the bronchial arteries were detected and successfully embolized. All patients profited from the therapy, as bleeding could be stopped or at least be reduced. 3 patients suffered from back pain during or after intervention. There were no severe complications like neurological deficiencies or necroses.

CONCLUSION: The embolization of bronchial arteries using particles and microcoils is an effective intervention with a low complication rate in pulmonary bleeding of CF patients.

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