Impact of MDCT angiography on the management of patients with hemoptysis.
OBJECTIVE
The aim of this study was to evaluate the ability of MDCT angiography to modify early results in patients undergoing endovascular embolization for hemoptysis.


METHODS
A comparative study was performed of two consecutive cohorts with 200 patients each who were treated by endovascular embolization for severe hemoptysis; one cohort underwent MDCT angiography and the other did not, but patients underwent further exploration with global aortography. We compared the two groups for patients' age and sex and for the volume, cause, and mechanisms of hemoptysis. Evaluation included the number of sessions needed to control the hemoptysis, the primary failure of bronchial artery embolization, the recurrence of hemoptysis, pulmonary artery vasoocclusion, urgent surgical resection, and death by massive hemoptysis during hospitalization. Failure was defined as the absence of embolization during the first session. Recurrence was defined as rebleeding despite technically successful bronchial artery embolization.


RESULTS
Differences between the groups were statistically significant for patient age (p < 0.05), endovascular treatment failure among patients older than 70 years (p < 0.05), pulmonary artery vasoocclusion in comparison with diagnostic pulmonary artery angiography (p < 0.0001), and urgent surgical resection (p = 0.034).


CONCLUSIONS
The impact of MDCT angiography was significant in reducing the rate of vascular catheterization failure in patients older than 70 years, increasing the number of pulmonary artery vasoocclusions, and reducing the number of urgent surgical resection.
Khalil
Antoine
A
Radiology Department, AP-HP, Tenon Hospital, 4 Rue de la Chine, Paris 75020, France. antoine_khalil@yahoo.fr
Fartoukh
Muriel
M
Parrot
Antoine
A
Bazelly
Bernard
B
Marsault
Claude
C
Carette
Marie-France
MF
D000368:Aged; D000792:Angiography / Q000379:methods*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006469:Hemoptysis / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D012042:Registries; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome