Endovascular embolization for the management of cryptogenic massive hemoptysis in long-term smokers / 中华放射学杂志

ABSTRACT

ObjectiveTo determine the effectiveness of endovascular embolization in patients with cryptogenic massive hemoptysis who were all long-term smokers.Methods Aortography and subclavian artery angiography were performed in 21long-term smokers with cryptogenicmassive hemoptysis.Transarterial embolization (TAE) was performed in patients with detectable pathologic systemic arteries.The angiographic findings were reviewed and the clinical and follow-up CT results were observed.ResultsThe pathologic systemic arteries were all bronchial arteries (BAs) and thirty-five arteries were involved.The angiography demonstrated peripheral hyperplasia in all BAs,with 24 pathologic BAs supplying the right lung and 25 supplying the upper lobes.In thirty-five BAs,24 showed hypertrophy and 11 were normal.TAE of the pathologic BAs was successfully performed and cessation of bleeding was achieved in all patients.During follow-up,one patient had episodic bloody sputum after embolization and no recurrence in all patients.The follow-up CTdemonstratednoadditionalabnormalitybesidespre-existingpulmonaryemphysema.Conclusion Cryptogenic massive hemoptysis in long-term smokers efficiently treated by endovascular embolization of the responsible bronchial artery.