Advertisement

Emergency Radiology

, Volume 26, Issue 5, pp 501–506 | Cite as

Bronchial arterial embolization using a gelatin sponge for hemoptysis from pulmonary aspergilloma: comparison with other pulmonary diseases

  • Masashi ShimohiraEmail author
  • Kengo Ohta
  • Keiichi Nagai
  • Yusuke Sawada
  • Masahiro Nakashima
  • Hiroyuki Maki
  • Yuya Bando
  • Yuta Shibamoto
Original Article
  • 61 Downloads

Abstract

Purpose

To evaluate the clinical outcomes of bronchial artery embolization (BAE) using a gelatin sponge for hemoptysis from pulmonary aspergilloma and compare them with treatment outcomes for hemoptysis from other diseases.

Methods

Fifty-two patients underwent BAE using a gelatin sponge. The etiology of hemoptysis was pulmonary aspergilloma in 8 (PA group) and other diseases in 44 (control group). The technical success rate, clinical success rate, hemoptysis-free rate, and complication rate were compared between the PA group and control group. Technical success was defined as the complete cessation of the targeted feeding artery as confirmed by digital subtraction angiography, and clinical success as the cessation of hemoptysis within 24 h of BAE. Recurrent hemoptysis was defined as a single or multiple episodes of hemoptysis causing > 30 ml of bleeding per day.

Results

Technical and clinical success rates were 100% in both groups. Hemoptysis-free rates were 85% at 6 months and 72% at 12–60 months in the control group, and 38% at 6–12 months and 25% thereafter in the PA group (P = 0.0009). No complications were observed following BAE in any case in the two groups.

Conclusion

BAE using a gelatin sponge may not be effective for hemoptysis from pulmonary aspergilloma.

Keywords

Bronchial artery embolization Gelatin sponge Hemoptysis Pulmonary aspergilloma 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This retrospective study was approved by the Institutional Review Board.

Statement of informed consent

Written informed consent for the procedure was obtained from each patient.

References

  1. 1.
    White RI Jr (1999) Bronchial artery embolotherapy for control of acute hemoptysis: analysis of outcome. Chest 115(4):912–915CrossRefGoogle Scholar
  2. 2.
    Buckingham SJ, Hansell DM (2003) Aspergillus in the lung: diverse and coincident forms. Eur Radiol 13(8):1786–1800CrossRefGoogle Scholar
  3. 3.
    Soubani AO, Chandrasekar PH (2002) The clinical spectrum of pulmonary aspergillosis. Chest 12(6):1988–1999CrossRefGoogle Scholar
  4. 4.
    Patterson KC, Strek ME (2014) Diagnosis and treatment of pulmonary aspergillosis syndromes. Chest 146(5):1358–1368CrossRefGoogle Scholar
  5. 5.
    Zmeili OS, Soubani AO (2007) Pulmonary aspergillosis: a clinical update. QJM 100(6):317–334CrossRefGoogle Scholar
  6. 6.
    Yoon W, Kim JK, Kim YH, Chung TW, Kang HK (2002) Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review. Radiographics 22(6):1395–1409CrossRefGoogle Scholar
  7. 7.
    Panda A, Bhalla AS, Goyal A (2017) Bronchial artery embolization in hemoptysis: a systematic review. Diagn Interv Radiol 23(4):307–317CrossRefGoogle Scholar
  8. 8.
    Kato A, Kudo S, Matsumoto K, Fukahori T, Shimizu T, Uchino A, Hayashi S (2000) Bronchial artery embolization for hemoptysis due to benign diseases: immediate and long-term results. Cardiovasc Intervent Radiol 23(5):351–357CrossRefGoogle Scholar
  9. 9.
    Shimohira M, Hashimoto T, Abematsu S, Hashizume T, Nakagawa M, Ozawa Y, Sakurai K, Shibamoto Y (2015) Triaxial system in bronchial arterial embolization for haemoptysis using N-butyl-2-cyanoacrylate. Br J Radiol 88(1056):20150265CrossRefGoogle Scholar
  10. 10.
    Chun JY, Morgan R, Belli AM (2010) Radiological management of hemoptysis: a comprehensive review of diagnostic imaging and bronchial arterial embolization. Cardiovasc Intervent Radiol 33(2):240–250CrossRefGoogle Scholar
  11. 11.
    Woo S, Yoon CJ, Chung JW, Kang SG, Jae HJ, Kim HC, Seong NJ, Kim YJ, Woo YN (2013) Bronchial artery embolization to control hemoptysis: comparison of N-butyl-2-cyanoacrylate and polyvinyl alcohol particles. Radiology 269(2):594–602CrossRefGoogle Scholar
  12. 12.
    Anuradha C, Shyamkumar NK, Vinu M, Babu NR, Christopher DJ (2012) Outcomes of bronchial artery embolization for life-threatening hemoptysis due to tuberculosis and post-tuberculosis sequelae. Diagn Interv Radiol 18(1):96–101Google Scholar
  13. 13.
    Sacks D, McClenny TE, Cardella JF, Lewis CA (2003) Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 14(9 Pt 2):S199–S202CrossRefGoogle Scholar
  14. 14.
    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(3):637–644CrossRefGoogle Scholar
  15. 15.
    Inoue K, Matsuyama W, Hashiguchi T, Wakimoto J, Hirotsu Y, Kawabata M, Arimura K, Osame M (2001) Expression of vascular endothelial growth factor in pulmonary aspergilloma. Intern Med 40(12):1195–1199CrossRefGoogle Scholar
  16. 16.
    Corr P (2006) Management of severe hemoptysis from pulmonary aspergilloma using endovascular embolization. Cardiovasc Intervent Radiol 29(5):807–810CrossRefGoogle Scholar
  17. 17.
    Pump K (1972) Distribution of bronchial arteries in human lung. Chest 62(4):447–451CrossRefGoogle Scholar
  18. 18.
    Tanaka N, Yamakado K, Murashima S, Takeda K, Matsumura K, Nakagawa T, Takano K, Ono M, Hattori T (1997) Superselective bronchial artery embolization for hemoptysis with a coaxial microcatheter system. J Vasc Interv Radiol 8(1 Pt 1):65–70CrossRefGoogle Scholar
  19. 19.
    Hayakawa K, Tanaka F, Torizuka T, Mitsumori M, Okuno Y, Matsui A, Satoh Y, Fujiwara K, Misaki T (1992) Bronchial artery embolization for hemoptysis: immediate and long-term results. Cardiovasc Intervent Radiol 15(3):154–158 discussion 158-159CrossRefGoogle Scholar
  20. 20.
    Hahn S, Kim YJ, Kwon W, Cha SW, Lee WY (2010) Comparison of the effectiveness of embolic agents for bronchial artery embolization: gelfoam versus polyvinyl alcohol. Korean J Radiol 11(5):542–546CrossRefGoogle Scholar
  21. 21.
    Chun JY, Belli AM (2010) Immediate and longterm outcomes of bronchial and nonbronchial systemic artery embolisation for the management of haemoptysis. Eur Radiol 20(3):55865CrossRefGoogle Scholar
  22. 22.
    Tsukada J, Hasegawa I, Torikai H, Sayama K, Jinzaki M, Narimatsu Y (2015) Interventional therapeutic strategy for hemoptysis originating from infectious pulmonary artery pseudoaneurysms. J Vasc Interv Radiol 26(7):1046–1051.e1CrossRefGoogle Scholar
  23. 23.
    Ding WY, Chan T, Yadavilli RK, McWilliams R (2014) Aspergilloma and massive haemoptysis. BMJ Case Rep 16:2014Google Scholar

Copyright information

© American Society of Emergency Radiology 2019

Authors and Affiliations

  • Masashi Shimohira
    • 1
    Email author
  • Kengo Ohta
    • 1
  • Keiichi Nagai
    • 1
  • Yusuke Sawada
    • 1
  • Masahiro Nakashima
    • 1
  • Hiroyuki Maki
    • 1
  • Yuya Bando
    • 1
  • Yuta Shibamoto
    • 1
  1. 1.Department of RadiologyNagoya City University Graduate School of Medical SciencesNagoyaJapan

Personalised recommendations