Endovascular treatment of hemoptysis: influence of the type of pathology on the post embolization prognosis

To describe the course of patients with hemoptysis following embolization of the arteries involved, assessing the incidence of re bleeding in patients grouped according to type of pathology. Over the past five years, we have carried out 77 embolization in bronchial and other systemic arteries in 64 patients (46 men and 18 women) ranging in age from 18 to 83 years (mean: 54±15 years). The underlying diseases were active tuberculosis (n=11), latent tuberculosis (n=15), bronchiectasis (n=14), aspergilloma (n=3), pulmonary neoplasm (n=10), lung abscess (n=10) and miscellaneous conditions (n=10). Rebleeding occurred in 25 patients (32%). Of these, 13 had to undergo repeat embolization, 7 were treated surgically and 3 died during the recurrence of hemoptysis. In two cases, no diseased arteries could be found and embolization was not performed. The overall hemostatic efficacy was 86% after 7 days, 78% after one month and 61% after one year. In the patients with tuberculosis, the rates were 96% at one week and 91% at one month and one year, while among the remaining groups (with neoplasm, abscess, etc.), the incidences were 80% at day 7,70% at one month and 42% at one year. According to our experience, rebleeding occurs most frequently among patients with diseases other than tuberculosis. In these cases, follow-up should be closer and other therapeutic alternatives (surgery, radiotherapy, endobronchial laser) should be considered as a complement to percutaneous endovascular treatment. (Author) 22 refs