title: Pulmonary artery access embolization in patients with massive hemoptysis in whom bronchial and/or nonbronchial systemic artery embolization is contraindicated.
abstract: The objective of this paper is to present an alternative therapeutic approach for the treatment of patients with massive hemoptysis in whom bronchial and/or nonbronchial systemic arterial embolization is not possible. We describe a percutaneous procedure for pulmonary segmental artery embolization. Between May 2000 and July 2006, 27 adult patients with hemoptysis underwent percutaneous treatment at our department; 20 of 27 patients were embolized via bronchial and or nonbronchial systemic arteries and 7 patients were embolized via pulmonary artery. Femoral arterial access for systemic artery catheterization and femoral vein access for pulmonary arterial catheterization were used. Gelfoam particles and coils were used for embolization. In this study, we report on three cases of massive hemoptysis from a systemic arterial source in whom bronchial and/or nonbronchial arteries embolization was not possible. Percutaneous embolization via the pulmonary artery access was successful in all three patients. In conclusion, embolization via pulmonary artery is presented as an alternative approach for the management of hemoptysis in patients in whom bronchial arterial embolization is not possible.
authors.affiliation: Department of Hemodynamics, Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina.
authors.forename: Alberto
authors.initials: A
authors.lastname: Tamashiro
authors.forename: Marisa H
authors.initials: MH
authors.lastname: Miceli
authors.forename: Cristian
authors.initials: C
authors.lastname: Rando
authors.forename: Gustavo A
authors.initials: GA
authors.lastname: Tamashiro
authors.forename: Miguel O
authors.initials: MO
authors.lastname: Villegas
authors.forename: Andrés E
authors.initials: AE
authors.lastname: Dini
authors.forename: Aristóbulo E
authors.initials: AE
authors.lastname: Balestrin
authors.forename: José A
authors.initials: JA
authors.lastname: Diaz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D017130:Angioplasty; D001981:Bronchial Arteries; D002404:Catheterization / Q000379:methods; D015331:Cohort Studies; D000075202:Contraindications; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006469:Hemoptysis / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome