Interventional embolization treatment of massive hemoptysis in elderly patients with pulmonary tuberculosis complicated by aspergillosis

Objective: To retrospectively analyze the effectiveness of percutaneous bronchial artery embolization (BAE) for the treatment of massive hemoptysis due to pulmonary tuberculosis complicated by aspergillosis in elderly patients. Methods: BAE and relevant angiography was performed in 15 massive hemoptysis elderly patients with confirmed pulmonary tuberculosis complicated by aspergillosis to determine the types and numbers of diseased arteries. BAE was carried out for the responsible arteries. Results: A total of 39 bleeding arteries were detected in 15 patients, including bronchial artery (n = 21, 53.85%), intercostal artery (n = 10, 25.64%), internal thoracic artery (n = 6, 15.38%) and inferior phrenic artery (n = 2, 5.13%). Embolization treatment was carried out for all the bleeding arteries. Immediate hemostasis after successful embolization was obtained in 13 patients (86.67%). In one patient, massive hemoptysis appeared again within 24 hours after the embolization therapy and the bleeding stopped after second embolization procedure. In another patient, intermittent and small amount of hemoptysis developed after embolizaton treatment, and the hemoptysis stopped after symptomatic treatment. No severe complications occurred. Conclusion: For the treatment of massive hemoptysis caused by pulmonary tuberculosis complicated by aspergillosis, which has failed to medical treatment and is inoperable, BAE is an effective and life-saving hemostasis method. (authors)