Evaluation of the technical details of bronchoscopic endobronchial sealing : Review of 67 patients

Background. Management of haemoptysis not responding to conservative management is often difficult. Bronchial artery embolisation is costly and often not accessible, especially in the resource poor areas. Hence, surgery often remains the only therapeutic option despite its high morbidity and mortality. Therefore, an alternative easy but effective therapy is required. Endobronchial sealing is a recently described new method of therapy for haemoptysis. Methods. We carried out transcatheter endobronchial sealing procedure using an injection of n-butyl cyanoacrylate in 67 patients of haemoptysis with the help of a fiberoptic bronchoscope. The patients were followed up for a mean period of six months to document the recurrence of bleeding or other complications. Results. The success rate on long term follow up was 79.1 percent. There were procedure failures in 21.9%; the cause being false localisation (46.15%), proximal or inappropriate placement of the glue (30.79%) and difficult cannulation (23.0%). Conclusions. Endobronchial gluing with n-butyl cyanoacrylate appears to be an efficient, safe and simple method for treating haemoptysis. The success depends on the proper identification of the bleeding bronchus and the appropriate placement of the glue.