Bronchial Artery Embolization for Hemoptysis

Manrita Sidhu; Karen Wieseler; Thomas R. Burdick; Dennis W. W. Shaw

doi:10.1055/s-0028-1085931

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Semin intervent Radiol 2008; 25(3): 310-318
DOI: 10.1055/s-0028-1085931

Bronchial Artery Embolization for Hemoptysis

Manrita Sidhu¹ ^, ² ^, ⁴ , Karen Wieseler² , Thomas R. Burdick² ^, ³ , Dennis W. W Shaw¹ ^, ²

¹Children's Hospital and Regional Medical Center, Seattle, Washington
²University of Washington School of Medicine, Seattle, Washington
³Harborview Medical Center, Seattle, Washington
⁴Seattle Radiologists, Advanced Imaging Center, Everett, Washington

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Publication Date:
30 September 2008 (online)

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ABSTRACT

Bronchial artery bleeding is the most common cause of life-threatening hemoptysis. The most common underlying etiologies include tuberculosis, bronchiectasis, aspergillosis, and cystic fibrosis. Bronchial artery embolization is an important treatment for significant hemoptysis, given its high early success rate and relatively low risk compared with alternative medical and surgical treatments. In this article, the relevant anatomy and pathophysiology leading to bronchial artery bleeding is discussed, including the roles of parenchymal lung diseases and of collateral and aberrant vessels. The indications for treatment, success rate, and complication rate for bronchial artery embolization are reviewed. Preprocedure clinical stabilization and evaluation, including the roles of radiographs, bronchoscopy, and computed tomography examination are evaluated. Details of technique, including the published variety of approaches, and an emphasis on avoidance of nontarget embolization of important mediastinal structures and of the anterior spinal artery are discussed.

KEYWORDS

Hemoptysis - bronchial artery - embolization - selective angiography

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Manrita SidhuM.D.

Seattle Radiologists, Advanced Imaging Center

3927 Rucker Avenue, Everett, WA 98201

Email: manritasidhu@gmail.com