MASSIVE HEMOPTYSIS DUE TO PULMONARY TUBERCULOSIS - CONTROL WITH BRONCHIAL ARTERY EMBOLIZATION

PURPOSE: To determine the efficacy of bronchial artery embolization in the control of massive hemoptysis due to pulmonary tuberculosis. MATE RIALS AND METHODS: Between 1988 and 1994, 140 patients (125 men and 15 women; mean age, 31.5 years) who presented with massive hemoptysis (m ore than 300 mL of blood in 24 hours) underwent bronchial artery embol ization. Fifty-one patients had received no antituberculosis drugs. Br onchial artery embolization was performed on the side with the greater abnormality on the chest radiograph. Catheters (4 F) and a gelatin sp onge were used for embolization. Inflammatory hypervascularity was see n in all patients (five patients had contrast material extravasation a nd 10 patients had pseudoaneurysms). RESULTS: Almost complete control of hemoptysis was achieved in 102 patients. Of the remaining 38 patien ts with a notable amount of bleeding after the procedure, 29 were trea ted successfully with conservative measures and nine underwent reembol ization. Seven patients who underwent reembolization had recurrent ble eding; four of these patients underwent successful surgery, and three died of aspiration. Two patients developed transient paraparesis 6 hou rs 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 hem optysis due to pulmonary tuberculosis should first be treated with bro nchial artery embolization.