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JOURNAL ARTICLE

Massive hemoptysis due to pulmonary tuberculosis: control with bronchial artery embolization

R Ramakantan, V G Bandekar, M S Gandhi, B G Aulakh, H L Deshmukh
Radiology 1996, 200 (3): 691-4
8756916

PURPOSE: To determine the efficacy of bronchial artery embolization in the control of massive hemoptysis due to pulmonary tuberculosis.

MATERIALS AND METHODS: Between 1988 and 1994, 140 patients (125 men and 15 women; mean age, 31.5 years) who presented with massive hemoptysis (more than 300 mL of blood in 24 hours) underwent bronchial artery embolization. Fifty-one patients had received no antituberculosis drugs. Bronchial artery embolization was performed on the side with the greater abnormality on the chest radiograph. Catheters (4 F) and a gelatin sponge were used for embolization. Inflammatory hypervascularity was seen in all patients (five patients had contrast material extravasation and 10 patients had pseudoaneurysms).

RESULTS: Almost complete control of hemoptysis was achieved in 102 patients. Of the remaining 38 patients with a notable amount of bleeding after the procedure, 29 were treated successfully with conservative measures and nine underwent re-embolization. Seven patients who underwent re-embolization had recurrent bleeding; four of these patients underwent successful surgery, and three died of aspiration. Two patients developed transient paraparesis 6 hours after the procedure. Nine patients reported transient referred pain to the ipsilateral orbit during injection of the gelatin sponge. One patient had transient dysphagia.

CONCLUSION: Patients with massive hemoptysis due to pulmonary tuberculosis should first be treated with bronchial artery embolization.

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