ROLE OF BRONCHIAL ARTERY EMBOLIZATION IN THE MANAGEMENT OF HEMOPTYSIS

Objective: To assess the modern morbidity of hemoptysis and the contri bution of therapeutic bronchial artery embolization to its management. Methods: Medical record review of patients admitted for the treatment of hemoptysis from January 1991 to November 1995 and of patients who had therapeutic bronchial artery embolization from June 1986 to August 1995. Hemoptysis was labeled major or minor. Results: A total of 138 patients were admitted with hemoptysis, 31 with major and 107 with min or hemoptysis. No emergency pulmonary resections were required. Mean f ollow-up was 13.5 months. Mortality was 29.7% (41/138) but was caused by bronchial bleeding in only 4.3% (6/138). Twenty-six patients underw ent therapeutic bronchial artery embolization (mean follow-up [range], 14 months [0.3-69.0 months]). The initial success rate (no further bl eeding during the initial admission) was 85% (22/26). The long-term su ccess rate (no further bleeding during follow-up) was 58% (15/26). Onl y 2 patients with therapeutic bronchial artery embolization died of fu rther hemoptysis. Conclusions: Hemoptysis signals life-threatening dis eases. Therapeutic bronchial artery embolization is a good treatment a djunct to control bronchial bleeding and reduces the need for high-ris k emergency lung resections.