Clinical Application Of Selective Bronchial Artery Embolization (BAE)in The Treatment Of Hemoptysis

Objective:Selective bronchial arteriography and embolization is an uneffective, hemostasis method for uncontrolled haemoptysis refractory to medical treatment, as well as for recurrent hemoptysis in patients who are not fit for surgical intervention. The study aims to evaluatethe clinical value of bronchial arteriography and embolization, as well as to compare the relative clinical efficacy of pure gelatin sponge embolization and permanent joint embolization.Materials and methods:Our study included197cases of patients with massive hemoptysis who received BAE therapy in our hospital from January2003to May2014. Feeder arteries to the bleeding points identified by bronchial angiography were subsequently embolizedby either pure gelatin sponge microparticles (Group A) or embolization micro coils combined with gelatin sponge microparticles (Group B). All procedures were performed and access to the bronchial artery was achieved via femoral arterial puncture and catheterization using the Seldinger technique. Both intervention groups were followed up for at least6months, and data on clinical outcomes both immediate, early and medium to long term post procedure were collected.Results:Extravasation of contrast medium was scarcely noted in the197cases which underwent bronchial angiography. There are indirect or mixed features on the bronchial angiographic images. The clinical effectiveness of super-selective bronchial artery embolization in the short term treatment was100%.The recurrence rate for Group A (43patients)is44.2%while the recurrence rate for Group B (147patients)6.1%.The recurrent cases were re treated with embolization with no subsequent recurrence.Conclusion:Our study have demonstrated that BAE is a safe, technically easy and highly effective method for the treatment of massive hemoptysis. Statistical analysis of the data have shown that the polyvinyl alcohol and gelatin sponge micro particles in bronchial artery embolization forthe treatment of massive hemoptysis can significantly reduce the recurrence of hemoptysis. Therefore, we propose that bronchial artery embolization using the combination of microcoils and microparticles be more widely used, so as to provide patients with a safer and minimally invasive option that has a lower rate of complications..