Semin intervent Radiol 2022; 39(03): 210-217
DOI: 10.1055/s-0042-1751293
Review Article

Bronchial Artery Embolization

Claire S. Kaufman
1   Dotter Department of Interventional Radiology, Oregon Health & Sciences University, Portland, Oregon
,
Sharon W. Kwan
1   Dotter Department of Interventional Radiology, Oregon Health & Sciences University, Portland, Oregon
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Abstract

Massive hemoptysis is a highly morbid medical condition with up to 75% mortality with conservative treatment. Bronchial artery embolization has emerged as the common treatment for both acute massive hemoptysis and chronic hemoptysis. This article will review the clinical presentation, bronchial artery anatomy, embolization procedure, complications, and expected outcomes.

Keywords

bronchial artery embolization - embolization - hemoptysis - interventional radiology


Publication History

Article published online:
31 August 2022

© 2022. Thieme. All rights reserved.

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  • References

  • 1 Davidson K, Shojaee S. Managing massive hemoptysis. Chest 2020; 157 (01) 77-88
    Google Scholar
  • 2 Lee BR, Yu JY, Ban HJ. et al. Analysis of patients with hemoptysis in a tertiary referral hospital. Tuberc Respir Dis (Seoul) 2012; 73 (02) 107-114
    CrossrefPubMedGoogle Scholar
  • 3 Ong TH, Eng P. Massive hemoptysis requiring intensive care. Intensive Care Med 2003; 29 (02) 317-320
    CrossrefPubMedGoogle Scholar
  • 4 Reechaipichitkul W, Latong S. Etiology and treatment outcomes of massive hemoptysis. Southeast Asian J Trop Med Public Health 2005; 36 (02) 474-480
    PubMedGoogle Scholar
  • 5 Najarian KE, Morris CS. Arterial embolization in the chest. J Thorac Imaging 1998; 13 (02) 93-104
    CrossrefPubMedGoogle Scholar
  • 6 Fernando HC, Stein M, Benfield JR, Link DP. Role of bronchial artery embolization in the management of hemoptysis. Arch Surg 1998; 133 (08) 862-866
    CrossrefPubMedGoogle Scholar
  • 7 Corey R, Hla KM. Major and massive hemoptysis: reassessment of conservative management. Am J Med Sci 1987; 294 (05) 301-309
    CrossrefPubMedGoogle Scholar
  • 8 Amirana M, Frater R, Tirschwell P, Janis M, Bloomberg A, State D. An aggressive surgical approach to significant hemoptysis in patients with pulmonary tuberculosis. Am Rev Respir Dis 1968; 97 (02) 187-192
    PubMedGoogle Scholar
  • 9 Yoon W, Kim JK, Kim YH, Chung TW, Kang HK. Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review. Radiographics 2002; 22 (06) 1395-1409
    CrossrefPubMedGoogle Scholar
  • 10 Patwa A, Shah A. Anatomy and physiology of respiratory system relevant to anaesthesia. Indian J Anaesth 2015; 59 (09) 533-541
    CrossrefPubMedGoogle Scholar
  • 11 Radchenko C, Alraiyes AH, Shojaee S. A systematic approach to the management of massive hemoptysis. J Thorac Dis 2017; 9 (Suppl. 10) S1069-S1086
    CrossrefPubMedGoogle Scholar
  • 12 Remy J, Voisin C, Ribet M. et al. [Treatment, by embolization, of severe or repeated hemoptysis associated with systemic hypervascularization]. Nouv Presse Med 1973; 2 (31) 2060
    PubMedGoogle Scholar
  • 13 Kalva SP. Bronchial artery embolization. Tech Vasc Interv Radiol 2009; 12 (02) 130-138
    CrossrefPubMedGoogle Scholar
  • 14 Panda A, Bhalla AS, Goyal A. Bronchial artery embolization in hemoptysis: a systematic review. Diagn Interv Radiol 2017; 23 (04) 307-317
    CrossrefPubMedGoogle Scholar
  • 15 Jean-Baptiste E. Clinical assessment and management of massive hemoptysis. Crit Care Med 2000; 28 (05) 1642-1647
    CrossrefPubMedGoogle Scholar
  • 16 Earwood JS, Thompson TD. Hemoptysis: evaluation and management. Am Fam Physician 2015; 91 (04) 243-249
    PubMedGoogle Scholar
  • 17 Abdulmalak C, Cottenet J, Beltramo G. et al. Haemoptysis in adults: a 5-year study using the French nationwide hospital administrative database. Eur Respir J 2015; 46 (02) 503-511
    CrossrefPubMedGoogle Scholar
  • 18 Ittrich H, Bockhorn M, Klose H, Simon M. The diagnosis and treatment of hemoptysis. Dtsch Arztebl Int 2017; 114 (21) 371-381
    CrossrefPubMedGoogle Scholar
  • 19 Arooj P, Bredin E, Henry MT. et al. Bronchoscopy in the investigation of outpatients with hemoptysis at a lung cancer clinic. Respir Med 2018; 139: 1-5
    CrossrefPubMedGoogle Scholar
  • 20 Savale L, Parrot A, Khalil A. et al. Cryptogenic hemoptysis: from a benign to a life-threatening pathologic vascular condition. Am J Respir Crit Care Med 2007; 175 (11) 1181-1185
    CrossrefPubMedGoogle Scholar
  • 21 Singh SK, Tiwari KK. Etiology of hemoptysis: a retrospective study from a tertiary care hospital from northern Madhya Pradesh, India. Indian J Tuberc 2016; 63 (01) 44-47
    CrossrefPubMedGoogle Scholar
  • 22 Gagnon S, Quigley N, Dutau H, Delage A, Fortin M. Approach to hemoptysis in the modern era. Can Respir J 2017; 2017: 1565030
    CrossrefPubMedGoogle Scholar
  • 23 Sehgal IS, Dhooria S, Agarwal R, Behera D. Use of a flexible cryoprobe for removal of tracheobronchial blood clots. Respir Care 2015; 60 (07) e128-e131
    CrossrefPubMedGoogle Scholar
  • 24 Conlan AA, Hurwitz SS. Management of massive haemoptysis with the rigid bronchoscope and cold saline lavage. Thorax 1980; 35 (12) 901-904
    CrossrefPubMedGoogle Scholar
  • 25 Sakr L, Dutau H. Massive hemoptysis: an update on the role of bronchoscopy in diagnosis and management. Respiration 2010; 80 (01) 38-58
    CrossrefPubMedGoogle Scholar
  • 26 Lee S, Chan JW, Chan SC. et al. Bronchial artery embolisation can be equally safe and effective in the management of chronic recurrent haemoptysis. Hong Kong Med J 2008; 14 (01) 14-20
    PubMedGoogle Scholar
  • 27 Swanson KL, Johnson CM, Prakash UB, McKusick MA, Andrews JC, Stanson AW. Bronchial artery embolization: experience with 54 patients. Chest 2002; 121 (03) 789-795
    CrossrefPubMedGoogle Scholar
  • 28 Dabó H, Gomes R, Marinho A, Madureira M, Paquete J, Morgado P. Bronchial artery embolisation in management of hemoptysis – a retrospective analysis in a tertiary university hospital. Rev Port Pneumol (2006) 2016; 22 (01) 34-38
    PubMedGoogle Scholar
  • 29 Loiudice G, Catelli A, Corvino A, Quarantelli M, Venetucci P. Endovascular treatment of chronic hemoptysis in patients with pulmonary tuberculosis. Acta Biomed 2021; 92 (03) e2021201
    PubMedGoogle Scholar
  • 30 Tanomkiat W, Tanisaro K. Radiographic relationship of the origin of the bronchial arteries to the left main bronchus. J Thorac Imaging 2003; 18 (01) 27-33
    CrossrefPubMedGoogle Scholar
  • 31 McCullagh A, Rosenthal M, Wanner A, Hurtado A, Padley S, Bush A. The bronchial circulation – worth a closer look: a review of the relationship between the bronchial vasculature and airway inflammation. Pediatr Pulmonol 2010; 45 (01) 1-13
    CrossrefPubMedGoogle Scholar
  • 32 Burke CT, Mauro MA. Bronchial artery embolization. Semin Intervent Radiol 2004; 21 (01) 43-48
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Sopko DR, Smith TP. Bronchial artery embolization for hemoptysis. Semin Intervent Radiol 2011; 28 (01) 48-62
    Article in Thieme ConnectPubMedGoogle Scholar
  • 34 Cauldwell EW, Siekert RG. et al. The bronchial arteries; an anatomic study of 150 human cadavers. Surg Gynecol Obstet 1948; 86 (04) 395-412
    CrossrefPubMedGoogle Scholar
  • 35 Brown AC, Ray CE. Anterior spinal cord infarction following bronchial artery embolization. Semin Intervent Radiol 2012; 29 (03) 241-244
    Article in Thieme ConnectPubMedGoogle Scholar
  • 36 Walker CM, Rosado-de-Christenson ML, Martínez-Jiménez S, Kunin JR, Wible BC. Bronchial arteries: anatomy, function, hypertrophy, and anomalies. Radiographics 2015; 35 (01) 32-49
    CrossrefPubMedGoogle Scholar
  • 37 Sancho C, Escalante E, Domínguez J. et al. Embolization of bronchial arteries of anomalous origin. Cardiovasc Intervent Radiol 1998; 21 (04) 300-304
    CrossrefPubMedGoogle Scholar
  • 38 Hartmann IJ, Remy-Jardin M, Menchini L, Teisseire A, Khalil C, Remy J. Ectopic origin of bronchial arteries: assessment with multidetector helical CT angiography. Eur Radiol 2007; 17 (08) 1943-1953
    CrossrefPubMedGoogle Scholar
  • 39 Loukas M, Hanna M, Chen J, Tubbs RS, Anderson RH. Extracardiac coronary arterial anastomoses. Clin Anat 2011; 24 (02) 137-142
    CrossrefPubMedGoogle Scholar
  • 40 Choi WS, Kim MU, Kim HC, Yoon CJ, Lee JH. Variations of bronchial artery origin in 600 patients: systematic analysis with multidetector computed tomography and digital subtraction angiography. Medicine (Baltimore) 2021; 100 (22) e26001
    CrossrefPubMedGoogle Scholar
  • 41 Shimohira M, Ohta K, Nagai K. et al. Bronchial arterial embolization using a gelatin sponge for hemoptysis from pulmonary aspergilloma: comparison with other pulmonary diseases. Emerg Radiol 2019; 26 (05) 501-506
    CrossrefPubMedGoogle Scholar
  • 42 Tanaka N, Yamakado K, Murashima S. et al. Superselective bronchial artery embolization for hemoptysis with a coaxial microcatheter system. J Vasc Interv Radiol 1997; 8 (1, Pt 1): 65-70
    CrossrefPubMedGoogle Scholar
  • 43 Lorenz J, Sheth D, Patel J. Bronchial artery embolization. Semin Intervent Radiol 2012; 29 (03) 155-160
    Article in Thieme ConnectPubMedGoogle Scholar
  • 44 Kucukay F, Topcuoglu OM, Alpar A, Altay CM, Kucukay MB, Ozbulbul NI. Bronchial artery embolization with large sized (700-900  µm) tris-acryl microspheres (Embosphere) for massive hemoptysis: long-term results (clinical research). Cardiovasc Intervent Radiol 2018; 41 (02) 225-230
    CrossrefPubMedGoogle Scholar
  • 45 Corr PD. Bronchial artery embolization for life-threatening hemoptysis using tris-acryl microspheres: short-term result. Cardiovasc Intervent Radiol 2005; 28 (04) 439-441
    CrossrefPubMedGoogle Scholar
  • 46 Fruchter O, Schneer S, Rusanov V, Belenky A, Kramer MR. Bronchial artery embolization for massive hemoptysis: long-term follow-up. Asian Cardiovasc Thorac Ann 2015; 23 (01) 55-60
    CrossrefPubMedGoogle Scholar
  • 47 Woo S, Yoon CJ, Chung JW. et al. Bronchial artery embolization to control hemoptysis: comparison of N-butyl-2-cyanoacrylate and polyvinyl alcohol particles. Radiology 2013; 269 (02) 594-602
    CrossrefPubMedGoogle Scholar
  • 48 Ayx I, Müller-Wille R, Wohlgemuth WA. et al. Treatment of acute hemoptysis by bronchial artery embolization with the liquid embolic agent ethylene vinyl alcohol copolymer. J Vasc Interv Radiol 2017; 28 (06) 825-831
    CrossrefPubMedGoogle Scholar
  • 49 San Norberto EM, Urbano García J, Montes JM, Vaquero C. Endovascular treatment of bronchial aneurysms. J Thorac Cardiovasc Surg 2018; 156 (02) e109-e117
    CrossrefPubMedGoogle Scholar
  • 50 Uflacker R, Kaemmerer A, Picon PD. et al. Bronchial artery embolization in the management of hemoptysis: technical aspects and long-term results. Radiology 1985; 157 (03) 637-644
    CrossrefPubMedGoogle Scholar
  • 51 Tayal M, Chauhan U, Sharma P, Dev R, Dua R, Kumar S. Bronchial artery embolization. What further we can offer?. Wideochir Inne Tech Malo Inwazyjne 2020; 15 (03) 478-487
    PubMedGoogle Scholar
  • 52 Park JH, Kim DS, Kwon JS, Hwang DH. Posterior circulation stroke after bronchial artery embolization. Neurol Sci 2012; 33 (04) 923-926
    CrossrefPubMedGoogle Scholar
  • 53 Laborda A, Tejero C, Fredes A, Cebrian L, Guelbenzu S, de Gregorio MA. Posterior circulation stroke after bronchial artery embolization. A rare but serious complication. Cardiovasc Intervent Radiol 2013; 36 (03) 860-863
    CrossrefPubMedGoogle Scholar
  • 54 Nisar T. A rare case of posterior circulation stroke caused by bronchial artery embolization. J Stroke Cerebrovasc Dis 2018; 27 (08) e153-e155
    CrossrefPubMedGoogle Scholar
  • 55 Liu SF, Lee TY, Wong SL, Lai YF, Lin AS. Transient cortical blindness: a complication of bronchial artery embolization. Respir Med 1998; 92 (07) 983-986
    CrossrefPubMedGoogle Scholar
  • 56 van Doorn CS, De Boo DW, Weersink EJM, van Delden OM, Reekers JA, van Lienden KP. Permanent cortical blindness after bronchial artery embolization. Cardiovasc Intervent Radiol 2013; 36 (06) 1686-1689
    CrossrefPubMedGoogle Scholar
  • 57 Ishikawa H, Ohbe H, Omachi N, Morita K, Yasunaga H. Spinal cord infarction after bronchial artery embolization for hemoptysis: a nationwide observational study in Japan. Radiology 2021; 298 (03) 673-679
    CrossrefPubMedGoogle Scholar
  • 58 van den Heuvel MM, Els Z, Koegelenberg CF, Naidu KM, Bolliger CT, Diacon AH. Risk factors for recurrence of haemoptysis following bronchial artery embolisation for life-threatening haemoptysis. Int J Tuberc Lung Dis 2007; 11 (08) 909-914
    PubMedGoogle Scholar
  • 59 Han K, Yoon KW, Kim JH, Kim GM. bronchial artery embolization for hemoptysis in primary lung cancer: a retrospective review of 84 patients. J Vasc Interv Radiol 2019; 30 (03) 428-434
    CrossrefPubMedGoogle Scholar
  • 60 Martin LN, Higgins L, Mohabir P, Sze DY, Hofmann LV. Bronchial artery embolization for hemoptysis in cystic fibrosis patients: a 17-year review. J Vasc Interv Radiol 2020; 31 (02) 331-335
    CrossrefPubMedGoogle Scholar
  • 61 Tom LM, Palevsky HI, Holsclaw DS. et al. Recurrent bleeding, survival, and longitudinal pulmonary function following bronchial artery embolization for hemoptysis in a U.S. adult population. J Vasc Interv Radiol 2015; 26 (12) 1806-13 .e1
    CrossrefPubMedGoogle Scholar
  • 62 Hwang HG, Lee HS, Choi JS, Seo KH, Kim YH, Na JO. Risk factors influencing rebleeding after bronchial artery embolization on the management of hemoptysis associated with pulmonary tuberculosis. Tuberc Respir Dis (Seoul) 2013; 74 (03) 111-119
    CrossrefPubMedGoogle Scholar