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CardioVascular and Interventional Radiology

, Volume 30, Issue 4, pp 638–643 | Cite as

Bronchial Artery and Systemic Artery Embolization in the Management of Primary Lung Cancer Patients with Hemoptysis

  • Hong Suk ParkEmail author
  • Young Il Kim
  • Hyae Young Kim
  • Jae-Ill Zo
  • Joo Hyuk Lee
  • Jin Soo Lee
Clinical Investigation

Abstract

Purpose

To assess the safety and effectiveness of arterial embolization in lung cancer patients with hemoptysis.

Methods

Nineteen primary lung cancer patients with hemoptysis underwent bronchial artery and systemic artery embolization from April 2002 to March 2005. There were 17 men and 2 women, with a mean age of 59 years. Histologic analysis revealed squamous cell carcinoma in 10 patients and poorly differentiated adenocarcinoma in 9 patients. The amount of hemoptysis was bleeding of 25–50 ml within 24 hr in 8 patients, recurrent blood-tinged sputum in 6, and bleeding of 100 ml or more per 24 hr in 5. Embolization was done with a superselective technique using a microcatheter and polyvinyl alcohol particles to occlude the affected vessels.

Results

Arterial embolization was technically successful in all patients and clinically successful in 15 patients (79%). The average number of arteries embolized was 1.2. Bronchial arteriography revealed staining (all patients), dilatation of the artery or hypervascularity (10 patients), and bronchopulmonary shunt (6 patients). The recurrence rate was 33% (5/15) and 11 patients were alive with a mean follow-up time of 148 days (30–349 days).

Conclusion

Arterial embolotherapy for hemoptysis in patients with primary lung cancer is an effective, safe therapeutic modality despite the fact the vascular changes are subtle on angiography.

Keywords

Bronchial arteries Hemoptysis Interventional radiology Lung Lung neoplasm Therapeutic embolization 

Notes

Acknowledgments

The authors thank Siunna Baek for her editorial assistance.

Reference

  1. 1.
    Uflacker R, Kaemmerer A, Picon PD, et al. (1985) Bronchial artery embolization in the management of hemoptysis: Technical aspects and long-term results. Radiology 157:637–644PubMedGoogle Scholar
  2. 2.
    Rabkin JE, Astafjev VI, Gothman LN, et al. (1987) Transcatheter embolization in the management of pulmonary hemorrhage. Radiology 163:361–365PubMedGoogle Scholar
  3. 3.
    Knott-Craig CJ, Oostuizen JG, Rossouw G, et al. (1993) Management and prognosis of massive hemoptysis. J Thorac Cardiovasc Surg 105:394–397PubMedGoogle Scholar
  4. 4.
    Ramakantan R, Bandekar VG, Gandhi MS, et al. (1996) Massive hemoptysis due to pulmonary tuberculosis: Control with bronchial artery embolization. Radiology 200:691–694PubMedGoogle Scholar
  5. 5.
    Fernando HC, Stein M, Benfield JR, et al. (1998) Role of bronchial artery embolization in the management of hemoptysis. Arch Surg 133:862–866PubMedCrossRefGoogle Scholar
  6. 6.
    Mal H, Rullon I, Mellot F, et al. (1999) Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Chest 115:996–1001PubMedCrossRefGoogle Scholar
  7. 7.
    Swanson KL, Johnson M, Prakash UB, et al. (2002) Bronchial artery embolization: Experience with 54 patients. Chest 121:789–795PubMedCrossRefGoogle Scholar
  8. 8.
    Goh PY, Lin M, Teo N, et al. (2002) Embolization for hemoptysis: A six-year review. Cardiovasc Intervent Radiol 25:17–25CrossRefGoogle Scholar
  9. 9.
    Alberg AJ, Samet JM (2003) Epidemiology of lung cancer. Chest 123:21S–49SPubMedCrossRefGoogle Scholar
  10. 10.
    Jemal A, Murray T, Ward E, et al. (2005) Cancer statistics, 2005. Cancer J Clin 55:10–30CrossRefGoogle Scholar
  11. 11.
    Winter SM, Ingbar DH (1988) Massive hemoptysis: Pathogenesis and management. J Intens Care Med 3:171–188CrossRefGoogle Scholar
  12. 12.
    Lung Cancer Symptoms. Available at http://www.lungcancerinfo.net/content/symptoms. Accessed August 24, 2005
  13. 13.
    Drooz AT, Lewis CA, Timothy EA, et al. (2003) Quality improvement guidelines for percutaneous transcatheter embolization. J Vasc Interv Radiol 14:S237–S242PubMedGoogle Scholar
  14. 14.
    Cohen AM, Doershuk CF, Stern RC (1990) Bronchial artery embolization to control hemoptysis in cystic fibrosis. Radiology 175:401–405PubMedGoogle Scholar
  15. 15.
    Sweezey NB, Fellows KE (1990) Bronchial artery embolization for severe hemoptysis in cystic fibrosis. Chest 97:1322–1326PubMedGoogle Scholar
  16. 16.
    Katoh O, Yamada H, Hiura K, et al. (1987) Bronchoscopic and angiographic comparison of bronchial arterial lesions in patients with hemoptysis. Chest 91:486–489PubMedGoogle Scholar
  17. 17.
    Hsiao EI, Kirsch CM, Kagawa FT, et al. (2001) Utility of fiberoptic bronchoscopy before bronchial artery embolization for massive hemoptysis. AJR Am J Roentgenol 177:861–867PubMedGoogle Scholar
  18. 18.
    Hirshberg B, Biran I, Glazer M, et al. (1997) Hemoptysis: Etiology, evaluation, and outcome in a tertiary referral hospital. Chest 112:440–444PubMedGoogle Scholar
  19. 19.
    Mauro MA, Burke CT, Jaques PF (2006) Transcatheter bronchial artery embolization for inflammation (hemoptysis). In: Baum S, Pentecoast MJ (eds) Abram’s angiography: Interventional radiology. Philadelphia: Lippincott Williams & Wilkins, pp 909–919Google Scholar
  20. 20.
    Marshall TJ, Jackson JE (1997) Vascular intervention in the thorax: Bronchial artery embolization for haemoptysis. Eur Radiol 7:1221–1227PubMedCrossRefGoogle Scholar
  21. 21.
    Revel MP, Fournier LS, Hennebicque AS, et al. (2002) Can CT replace bronchoscopy in the detection of the site and cause of bleeding in patients with large or massive hemoptysis? AJR Am J Roentgenol 179:1217–1224PubMedGoogle Scholar
  22. 22.
    Wong ML, Szkup P, Hopley MJ (2002) Percutaneous embolotherapy for life-threatening hemoptysis. Chest 121:95–102PubMedCrossRefGoogle Scholar
  23. 23.
    Saluja S, Henderson KJ, White RI (2000) Embolotherapy in the bronchial and pulmonary circulation. Radiol Clin North Am 38:425–448PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Hong Suk Park
    • 1
    Email author
  • Young Il Kim
    • 1
  • Hyae Young Kim
    • 1
  • Jae-Ill Zo
    • 1
  • Joo Hyuk Lee
    • 1
  • Jin Soo Lee
    • 1
  1. 1.Research Institute and Hospital, National Cancer Center KoreaGyeonggi-doKorea

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