[Embolization in the therapy of hemoptysis. The results of a combination of Spongostan/sclerosing drugs and the role of electrocoagulation].
The author's purpose was to evaluate the efficacy of therapeutic embolization in pulmonary hemorrhage performed with fibrin foam (Spongostan) suspended in sclerosing agents (hydroxy-polyethoxy-dodecane 3%, or natrium morruate 5%), and electrocoagulation (Biotrol, spa) as an alternative to surgery. Twenty patients were embolized: 17 with fibrin foam and sclerosing agents only, 2 with the addition of electrocoagulation and a Gianturco coil respectively, and 1 with electrocoagulation alone. The follow-up ranges from 3 to 42 months (average 22). A patient affected by aspergilloma died a few days after hemoptysis. The patient treated by electrocoagulation alone suffers from periodical hematic expectoration (spitting). The remaining 18 patients have not shown any pathological findings. In 2 cases the arterial occlusion was confirmed by angiography, while in 1 case partial arterial recanalization was observed. Such a finding was due to the vessel dimensions and to hyperflux values. In similar cases, obstruction must be completed by different techniques (e.g. Gianturco coils, electrocoagulation, detachable balloons, etc.). The absence of flux resulting from embolization improves electrocoagulation efficiency, which should be considered as the technique of choice. Even though additional trials are needed, the techniques have proven quite reliable and suitable to replace surgery in low-aggression lesions.
Gasparini
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Istituto di Radiologia II, Ospedale S. Maria della Misericordia, Udine.
D000328:Adult; D000368:Aged; D001981:Bronchial Arteries / Q000000981:diagnostic imaging; D003131:Combined Modality Therapy; D004564:Electrocoagulation; D004621:Embolization, Therapeutic / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D005339:Fibrin Foam / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006469:Hemoptysis / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D013535:Suspensions
D005339:Fibrin Foam; D012597:Sclerosing Solutions; D013535:Suspensions
L'embolizzazione nella terapia dell'emottisi. Risultati dell'associazione Spongostan/farmaci sclerotizzanti e ruolo dell'elettrocoagulazione.