Advertisement

CardioVascular and Interventional Radiology

, Volume 29, Issue 5, pp 807–810 | Cite as

Management of Severe Hemoptysis from Pulmonary Aspergilloma Using Endovascular Embolization

  • Peter Corr
Article

Abstract

Purpose

To determine the effectiveness of endovascular embolization as a temporizing measure in the management of severe hemoptysis caused by intracavitary pulmonary aspergilloma.

Methods

Patients presenting with hemoptysis, estimated to be more than 300 ml in the preceding 24 hr, in whom a radiological diagnosis of pulmonary aspergilloma was made on chest radiographs and/or computed tomography of the chest were subjected to bronchial and systemic arteriography and embolization using triacryl microspheres.

Results

Twelve patients with upper lobe intracavitary aspergillomas were managed with embolization. In 11 patients hemoptysis stopped within 24 hr and with no recurrence over the next 4 weeks. In 1 patient hemoptysis persisted and an upper lobe lobectomy was performed.

Conclusion

Embolization of bronchial and systemic arteries is an effective method for treating acute severe hemoptysis from intracavitary aspergillomas, allowing the patient time to recover for definitive surgical management.

Keywords

Aspergilloma Bronchial Embolization–Pulmonary 

References

  1. 1.
    White RI Jr (1999) Bronchial artery embolotherapy for control of acute hemoptysis: Analysis of outcome. Chest 115:912–915CrossRefPubMedGoogle Scholar
  2. 2.
    Buckingham SJ, Hansell D (2002) Aspergillus in the lung: Diverse and coincident forms. Eur Radiol 13:1786–1800CrossRefGoogle Scholar
  3. 3.
    Soubani AO, Chandrasekar PH (2002) The clinical spectrum of pulmonary aspergillosis. Chest 121:1988–1999CrossRefPubMedGoogle Scholar
  4. 4.
    Aslam PA, Eastridge CE, Hughes FA (1971) Aspergillosis of the lung: An eighteen year experience. Chest 58:28–32CrossRefGoogle Scholar
  5. 5.
    Uflacker R, Kaemmerer A, Picon PD, Rizzon CF, Neves CM, Oliveira ES, Oliveira ME, Azevedo SN, Ossanai R (1985) Bronchial artery embolization in the management of hemoptysis: Technical aspects and long-term results. Radiology 157:637–644CrossRefPubMedGoogle Scholar
  6. 6.
    Regnard JF, Icard P, Nicolosi M, Spargiaari L, Magdeniliat P, Jauffret B, Levasseur P (2000) Aspergilloma: A series of 89 surgical cases. Ann Thorac Surg 69:898–903CrossRefPubMedGoogle Scholar
  7. 7.
    Giron J, Poey C, Fajadet P (1990) CT-guided percutaneous treatment of inoperable pulmonary aspergillomas: A study of 40 cases. Eur J Radiol 28:235–242CrossRefGoogle Scholar
  8. 8.
    Corr PD (2005) Bronchial artery embolization for life-threatening hemoptysis using tri-acryl microspheres: Short term result. Cardiovasc Intervent Radiol 28:439–441CrossRefPubMedGoogle Scholar
  9. 9.
    Gefter WB (1992) The spectrum of pulmonary aspergillosis. J Thorac Imaging 7:56–74CrossRefPubMedGoogle Scholar
  10. 10.
    Franquet T, Muller NL, Gimenez A (2001) Spectrum of pulmonary aspergillosis: Histologic, clinical and radiologic findings. Radiographics 21:825–837CrossRefPubMedGoogle Scholar
  11. 11.
    Inoue K, Matsuyama W, Hashiguchi T (2001) Expression of vascular endothelial growth factor in pulmonary aspergilloma. Intern Med 40:1195–1199CrossRefPubMedGoogle Scholar
  12. 12.
    Hemphill RA (1946) Mycotic lung infection. Am J Med 1946:708–709CrossRefGoogle Scholar
  13. 13.
    Cubillo-Herguera E, McAlister WH (1969) The pulmonary meniscus sign in case of bronchogenic carcinoma. Radiology 92:1299–1300CrossRefPubMedGoogle Scholar
  14. 14.
    Evans WA (1943) Echinococcus cyst of the lung. Radiology 40:362–366CrossRefGoogle Scholar
  15. 15.
    Bard R (1975) Crescent sign in pulmonary hematoma. Radiology 32:247–251Google Scholar
  16. 16.
    Sansom HE, Baque-Juston M, Wells AU (2000) Lateral cavity thickening as an early radiographic sign of mycetoma formation. Eur Radiol 10:72–80CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of KwaZulu Natal, Nelson Mandela Medical SchoolCongellaSouth Africa

Personalised recommendations