Management of severe hemoptysis from pulmonary aspergilloma using endovascular embolization.
OBJECTIVE
To determine the effectiveness of endovascular embolization as a temporizing measure in the management of severe hemoptysis caused by intracavitary pulmonary aspergilloma.


METHODS
Patients presenting with hemoptysis, estimated to be more than 300 ml in the preceding 24 hr, in whom a radiological diagnosis of pulmonary aspergilloma was made on chest radiographs and/or computed tomography of the chest were subjected to bronchial and systemic arteriography and embolization using triacryl microspheres.


RESULTS
Twelve patients with upper lobe intracavitary aspergillomas were managed with embolization. In 11 patients hemoptysis stopped within 24 hr and with no recurrence over the next 4 weeks. In 1 patient hemoptysis persisted and an upper lobe lobectomy was performed.


CONCLUSIONS
Embolization of bronchial and systemic arteries is an effective method for treating acute severe hemoptysis from intracavitary aspergillomas, allowing the patient time to recover for definitive surgical management.
Corr
Peter
P
Department of Radiology, University of KwaZulu Natal, Nelson Mandela Medical School, Private bag 7, Congella 4013, Durban, South Africa. peter.corr@uaeu.ac.ae
D000208:Acute Disease; D000328:Adult; D001228:Aspergillosis / Q000150:complications* / Q000000981:diagnostic imaging; D001981:Bronchial Arteries; D001995:Bronchography; D004621:Embolization, Therapeutic; D005260:Female; D006469:Hemoptysis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008172:Lung Diseases, Fungal / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D013895:Thoracic Arteries; D014057:Tomography, X-Ray Computed