{"id":168,"date":"2012-04-25T10:17:00","date_gmt":"2012-04-25T10:17:00","guid":{"rendered":"http:\/\/www.kauveryhospital.com\/blog\/interventional-radiology-management-of-hemoptysis-coughing-up-blood\/"},"modified":"2023-03-13T09:21:44","modified_gmt":"2023-03-13T09:21:44","slug":"interventional-radiology-management-of-hemoptysis-coughing-up-blood","status":"publish","type":"post","link":"https:\/\/www.kauveryhospital.com\/blog\/radiology\/interventional-radiology-management-of-hemoptysis-coughing-up-blood\/","title":{"rendered":"Interventional Radiology Management of Hemoptysis (Coughing up blood)"},"content":{"rendered":"

Massive hemoptysis<\/strong><\/h2>\n

Massive hemoptysis (coughing up blood) is a life threatening condition with a mortality rate of 50 to 85 percent with conservative management<\/strong>.\u00a0embolization. Asphyxiation and less commonly exsanguination are the usual\u00a0causes of death. Aggressive management is required to manage these emergencies.<\/p>\n

Surgical resection of the causative lesion is the initial treatment of choice for those patients\u00a0with isolated abnormalities and adequate pulmonary reserve.<\/p>\n

However, patients with chronic\u00a0lung disease and limited pulmonary reserve are often considered unacceptable surgical risks,\u00a0and this group may benefit from \u00a0bronchial artery embolization.<\/p>\n

In addition, there is\u00a0some evidence that the surgical mortality rate may be lowered by preoperative bronchial artery\u00a0embolization in those patients who are actively bleeding. It is well established that safe and rapid\u00a0control of massive hemoptysis can often be obtained by therapeutic transcatheter embolization of\u00a0the bronchial arteries.<\/p>\n

More recently, moderate hemoptysis (greater than or equal to three episodes of 100 ml of\u00a0blood per day within 1 week) and even mild hemoptysis (chronic or slowly increasing\u00a0hemoptysis) are considered indications for transcatheter therapy.<\/p>\n

Also Read: 3D Imaging of Upper Respiratory Tract<\/a><\/div>\n

Bronchial artery<\/strong><\/h2>\n

Bronchial artery is the main source of bleed in patients with massive hemoptysis. \u00a0<\/strong>However, many non bronchial systemic arteries such as the intercostal arteries, internal mammary artery and inferior phrenic artery may also be the cause for bleed and it is essential to identify these vessels and embolise them for proper management. \u00a0MDCT with contrast can help in the identification of these vessels and acts as a roadmap for subsequent management.<\/p>\n

The embolisation procedure is done by an interventional radiologist<\/a> and takes approximately one hour time. It is performed in the cathlab under local anaesthesia. The main complication of this procedure is inadvertent embolisation of spinal artery which can result in paraplegia, but this is very unusual.<\/p>\n

\"Hypertrophied
\nHypertrophied Bronchial Artery Before Embolisation<\/p>\n

\"Post
\nPost Embolisation Image Showing Stasis of Contrast<\/p>\n

Dr. Iyappan Ponnuswamy<\/a> MD, FRCR<\/strong>
\nConsultant Interventional Radiologist, Kauvery Hospital, Chennai
\nPh: 044-30606345\u00a0 |\u00a0 Mob: 09551942599\u00a0 |\u00a0 \u00a0Email: driyappan@kauveryhospital.com<\/a><\/p>\n