retrospective analysis of 334 cases of hemoptysis treated by bronchial artery embolization

To analyze the safety and efficacy of bronchial artery embolization [BAE] in the management of hemoptysis. We conducted a retrospective study of 334 patients who had undergone BAE for hemoptysis from January 2007 to July 2013. Our study included 255 [76.3%] males and 79 [23.7%] females with an age range from five to 81 years old. All relevant arteries were evaluated but only those arteries that showed hypertrophy and significant blush were targeted. Polyvinyl alcohol [PVA] was used in all patients and gel foam was used in combination with PVA where there was significant shunting. Mild hemoptysis was seen in 70 patients, moderate in 195 patients, and severe in 69 patients. On imaging, right side disease was seen in 101 patients, left side involvement in 59 patients, and bilateral involvement in 174 patients. Post-tubercular changes were the predominant pathology seen in 248 patients. Among 334 patients [386 procedures], 42 patients underwent the procedure twice and five patients underwent the procedure thrice. A total of 485 arteries were attempted of which 440 arteries were successfully embolized. Right intercosto-bronchial was the most common culprit artery present in 157 patients, followed by common bronchial [n=97], left bronchial [n=55], and right bronchial [n=45]. We embolized a maximum of four arteries in one session. Immediate complications such as dissection and rupture occurred in only nine sessions [2.3%]. Twenty-five procedures [6.5%] were repeated within two months, which were due to technical or clinical failure and 27 procedures [7%] were repeated after two months. BAE is a safe and effective procedure with a negligible complication rate. Our approach of targeting hypertrophied arteries was effective

A comparative study to measure the condylar guidance by the radiographic and clinical methods

PURPOSE: The study was conducted to compare the radiographic and clinical methods of measuring the horizontal condylar guidance (HCG) values. MATERIALS AND METHODS: The condylar guidance was measured using the radiographic (CT scan) and three clinical methods i.e. the wax protrusive records, Lucia jig record and intraoral central bearing device in 12 patients aged between 20-40 years irrespective of sex. The records were taken and transferred on the semi-adjustable articulator to record the HCG values. The CT scan was taken for 3D reconstruction of the mid facial region. Frankfort horizontal plane (FHP) and a line extending from the superior anterior most point on the glenoid fossa to the most convex point on the apex of articular eminence (AE) was marked on the CT scan. An angle between these two lines was measured on both right and left sides to obtain condylar inclination angle. Three interocclusal protrusive wax and jig records were taken and transferred to the semi adjustable articulator. Three readings were recorded on each side. Similarly the records were taken and transferred to the same articulator using the intra oral central bearing device to record the readings. RESULTS: The statistical analysis showed insignificant differences in the HCG values between the right and left sides [(P=.589 (CT), P=.928 (wax), P=.625 (jig), P=.886 (tracer)]. The clinical methods provided low Pearsons correlation values [(R = 0.423 (wax), R = 0.354 (jig), R = 0.265 (tracer)] for the right as well as the left sides when compared with the CT values. Among the clinical methods, jig and wax method showed strong level of association which is statistically significant while the intra-oral tracer showed weak association with the other two methods. CONCLUSION: The right and left HCG values were almost similar. The CT scan showed higher HCG values than the clinical methods and among the clinical methods, values obtained from all the methods were comparable.