Management of severe hemoptysis due to pulmonary tuberculosis by bronchial artery embolisation

Objective : To assess the efficacy of bronchial artery embolization in the control of massive hemoptysis due to the sequelae of pulmonary tuberculosis. Material and Methods : Fifty patients, 28 men and 12 women between the ages of 14 to 58 years with a mean age of 40.5 years, were included in this study. All patients had severe hemoptysis (more than 300ml of blood in 24 hours) at the time of intervention. Pre-procedure bronchoscopy was not done. Bronchial artery embolization was performed on the side with the greater abnormality on the chest radiograph. Gel foam pieces (less than 3mm) were used as embolizing agents. These were introduced through a 4F visceral hook catheter. Pre and post-procedure angiographic films were obtained. Inflammatory hypervascularity, which regressed after embolisation, was seen in all patients. Results : Successful embolization was achieved in 47 patients. Two patients had recurrence and were re-embolised. In one patient the required artery could not be catheterized. Two patients had transient dysphagia. Mild chest pain lasting for 15 minutes was seen in 18 patients. Conclusion : Bronchial artery embolization is an effective procedure for the treatment of massive hemoptysis occurring due to the sequelae of pulmonary tuberculosis.