Arterial Embolization in the Chest

Najarian, Kenneth E.; Morris, Christopher S.

doi:10.1097/00005382-199804000-00004

Cited by 84 publications

(66 citation statements)

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“…However, this procedure requires a well-trained and experienced radiologist, because the bleeding vessels may originate not only from the bronchial artery but also from a nonbronchial systemic artery such as the intercostal or mammary arteries. Another complication of this technique is that the neurologic deficits may occur because some spinal arteries may arise from bronchial arteries (4).…”

Section: Discussionmentioning

confidence: 99%

Parallel Technique of Endobronchial Balloon Catheter Tamponade for Transient Alleviation of Massive Hemoptysis

2002

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Endobronchial balloon tamponade is an alternative method that can be used to control massive hemoptysis. Several different techniques have been used for this purpose. We describe a new parallel method, in which biopsy forceps introduced through a bronchoscope channel is used to grasp a balloon catheter. As the bronchoscope is advanced to the bleeding site, the balloon catheter is pulled into position, and subsequently inflated. There are several advantages of this technique. It needs no specialized catheter or guide wire, the procedure is relatively easy to perform, and applicable to other purposes such as introduction of an additional suction catheter. Fig. 5 presents the chest radiography after the procedure. The patient complained of intolerable throat pain four day after the catheter insertion. This discomfort subsided after removal of the catheters. There was no more hemoptysis after catheter removal and after 14 days the patient was transferred to the general ward. We recommended bronchial artery embolization but the patient and his family refused the procedure. The patient expired at 22 days after the procedure due to a recurrent sudden massive hemoptysis in spite of selective intubation and transfusion. DISCUSSIONSurgery for operable cases of massive hemoptysis has been reported to reduce the mortality to 18-23% (1, 2). This inter- Parallel Technique of Endobronchial Balloon Catheter Tamponade for Hemoptysis 825vention still has a high mortality and is not warranted for inoperable cases such as those with low lung reserve or other contraindicating medical problems. The results of bronchial artery embolization are often good. The initial success rate has been reported to be approximately 85% (3). However, this procedure requires a well-trained and experienced radiologist, because the bleeding vessels may originate not only from the bronchial artery but also from a nonbronchial systemic artery such as the intercostal or mammary arteries. Another complication of this technique is that the neurologic deficits may occur because some spinal arteries may arise from bronchial arteries (4).To decrease the mortality of massive hemoptysis, there should be a radical treatment followed by temporary blocking of bleeding and maintaining the patent airway with preserving lung tissue. But the single most important factor influencing mortality in massive hemoptysis is the rate of bleeding rather than the total amount of blood loss. Rapid flooding of the tracheobronchial tree causes the patient to drown in his own blood regardless of his age or the extent of underlying pulmonary disease (1). The primary objective for these patients should be prevention of asphyxia and exanguination.Endobronchial tamponade has been used as an alternative method for conservative management of massive hemoptysis (5). With previous techniques, the tamponade catheter has been introduced through the bronchoscope. The main challenge in performing this procedure is how to handle the distal cap of the balloon catheter. Several previous methods...

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Section: Discussionmentioning

confidence: 99%

Parallel Technique of Endobronchial Balloon Catheter Tamponade for Transient Alleviation of Massive Hemoptysis

2002

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“…31 Bronchial artery embolization (BAE) is a wellestablished procedure in the management of massive and recurrent hemoptysis. [42][43][44][45][46][47] Embolization in this territory is most commonly performed with particles such as PVA Figure 1 (A-D) Patient with massive epistaxis who has had three embolizations of the internal maxillary artery branches on both sides. The arteriography of the internal carotid artery shows the presence of a thick infraorbital artery that reaches the nostril and depends on the ophthalmic artery.…”

Section: Complications Of Embolization/bilbao Et Almentioning

confidence: 99%

Complications of Embolization

Simmen¹,

Jones²

2014

Manual of Endoscopic Sinus and Skull Base Surgery

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Embolization is a remarkably versatile procedure used in nearly all vascular and nonvascular systems to treat a wide range of pathology. The published literature is rich with studies demonstrating the enormous therapeutic potential offered by embolization procedures, and the possibilities continue to expand with the advent of new embolization agents and techniques. Unfortunately, with this variety and innovation comes a wide spectrum of potential complications, not always easy to classify and summarize, associated with embolization. This article reviews the procedures and associated complications of arterial and venous embolization procedures, organized by vascular distribution.

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“…83 Severe hemoptysis leading to uncontrolled bleeding and sudden death appears to be uncommon, with a mortality rate exceeding 50% if appropriate treatment is not immediately provided. [84][85][86][87][88] The source of massive hemoptysis 89 is predominantly the bronchial circulation (90%), rather than the pulmonary circulation (5%), and in a minority of cases it may originate from the aorta or the systemic arterial supply to the lungs. [90][91][92] In PAH the hypoxic vasoconstriction and the intravascular thrombosis 93 reduce pulmonary circulation, resulting in bronchial artery proliferation and enlargement.…”

Section: Hemoptysismentioning

confidence: 99%

Complications Leading to Sudden Cardiac Death in Pulmonary Arterial Hypertension

Demerouti

Manginas²,

Athanassopoulos

et al. 2012

Respir Care

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SummaryPulmonary arterial hypertension (PAH) is a disease of small pulmonary arteries, characterized by vascular proliferation and remodeling. Progressive increase in pulmonary vascular resistance ultimately leads to right ventricular heart failure and death. PAH-specific drug therapy has improved clinical outcomes and survival. While the survival is better, progression of pulmonary vasculopathy contributes to pulmonary artery dilatation. Left main compression syndrome, pulmonary artery dissection, pulmonary artery rupture, and severe hemoptysis are reported as complications leading to sudden cardiac death, an event encountered more often in PAH patients. The advent of PAHtargeted drug therapy has reduced referral for lung transplantation; however, severe complications require rapid diagnosis, decision making, and possible registration on a lung transplantation waiting list. PAH referral centers provide multidisciplinary emergency care and specific therapeutic management, contributing to improved quality of life and survival for PAH patients. We review the complications leading to sudden death in PAH. Key words: pulmonary hypertension; pulmonary artery dissection; pulmonary artery rupture; left main compression syndrome. [Respir Care 2013;58(7):1246 -1254.

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Arterial Embolization in the Chest

Cited by 84 publications

References 0 publications

Parallel Technique of Endobronchial Balloon Catheter Tamponade for Transient Alleviation of Massive Hemoptysis

Parallel Technique of Endobronchial Balloon Catheter Tamponade for Transient Alleviation of Massive Hemoptysis

Complications of Embolization

Complications Leading to Sudden Cardiac Death in Pulmonary Arterial Hypertension

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