Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00050590.xml
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(03): 361-372
DOI: 10.1055/s-0043-1762552
DOI: 10.1055/s-0043-1762552
Review Article
Society of Chest Imaging and Interventions Consensus Guidelines for the Interventional Radiology Management of Hemoptysis
Funding None.
Abstract
The recommendations from the Society of Chest Imaging and Interventions expert group comprehensively cover all the aspects of management of hemoptysis, highlighting the role of diagnostic and interventional radiology. The diversity existing in etiopathology, imaging findings, and management of hemoptysis has been addressed. The management algorithm recommends the options for effective treatment while minimizing the chances of recurrence, based on the best evidence available and opinion from the experts.
Keywords
interventional radiology - bronchial artery embolization - guidelines - hemoptysis - life-threatening hemoptysisPublication History
Article published online:
10 April 2023
© 2023. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References:
- 1 CIRSE Standards of Practice on Bronchial Artery Embolisation | SpringerLink [Internet]. Accessed October 3, 2022 at: https://link.springer.com/article/10.1007/s00270-022-03127-w
- 2 Rémy J, Rémy-Jardin M, Voisin C. Endovascular management of bronchial bleeding. Endovasc Manag Bronchial Bleeding 1992; 57: 667-723
- 3 Olsen KM, Manouchehr-Pour S, Donnelly EF. et al. Expert Panel on Thoracic Imaging. ACR Appropriateness Criteria® Hemoptysis. J Am Coll Radiol 2020; 17 (5S): S148-59
- 4 Kaufman CS, Kwan SW. Bronchial artery embolization. Semin Intervent Radiol 2022; 39 (03) 210-217
- 5 Radchenko C, Alraiyes AH, Shojaee S. A systematic approach to the management of massive hemoptysis. J Thorac Dis 2017; 9 (Suppl. 10) S1069-S1086
- 6 Magid DJ, Aziz K, Cheng A. et al. Part 2: evidence evaluation and guidelines development: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2020; 142 (16_Suppl_2, suppl_2): S358-S365
- 7 Cordovilla R, Bollo de Miguel E, Nuñez Ares A, Cosano Povedano FJ, Herráez Ortega I, Jiménez Merchán R. Diagnosis and treatment of hemoptysis [in Spanish]. Arch Bronconeumol 2016; 52 (07) 368-377
- 8 Etiology of hemoptysis in adults - UpToDate [Internet]. Accessed October 5, 2022 at: https://www.uptodate.com/contents/etiology-of-hemoptysis-in-adults?search=hemomptysis&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H11004209
- 9 Fartoukh M, Demoule A, Sanchez O. et al; ARTEMHYS trial group. Randomised trial of first-line bronchial artery embolisation for non-severe haemoptysis of mild abundance. BMJ Open Respir Res 2021; 8 (01) e000949
- 10 Panda A, Bhalla AS, Goyal A. Bronchial artery embolization in hemoptysis: a systematic review. Diagn Interv Radiol 2017; 23 (04) 307-317
- 11 Prasad R, Garg R, Singhal S, Srivastava P. Lessons from patients with hemoptysis attending a chest clinic in India. Ann Thorac Med 2009; 4 (01) 10-12
- 12 Bhalla A, Pannu AK, Suri V. Etiology and outcome of moderate-to-massive hemoptysis: experience from a tertiary care center of North India. Int J Mycobacteriol 2017; 6 (03) 307-310
- 13 Mondoni M, Carlucci P, Job S. et al. Observational, multicentre study on the epidemiology of haemoptysis. Eur Respir J 2018; 51 (01) 1701813
- 14 Hsiao EI, Kirsch CM, Kagawa FT, Wehner JH, Jensen WA, Baxter RB. Utility of fiberoptic bronchoscopy before bronchial artery embolization for massive hemoptysis. Am J Roentgenol 2001; 177 (04) 861-867
- 15 Revel MP, Fournier LS, Hennebicque AS. et al. Can CT replace bronchoscopy in the detection of the site and cause of bleeding in patients with large or massive hemoptysis?. Am J Roentgenol 2002; 179 (05) 1217-1224
- 16 Deshwal H, Sinha A, Mehta AC. Life-threatening hemoptysis. Semin Respir Crit Care Med 2021; 42 (01) 145-159
- 17 Sidhu M, Wieseler K, Burdick TR, Shaw DWW. Bronchial artery embolization for hemoptysis. Semin Intervent Radiol 2008; 25 (03) 310-318
- 18 Evaluation and management of life-threatening hemoptysis - UpToDate [Internet]. Accessed October 5, 2022 at: https://www.uptodate.com/contents/evaluation-and-management-of-life-threatening-hemoptysis
- 19 Jean-Baptiste E. Clinical assessment and management of massive hemoptysis. Crit Care Med 2000; 28 (05) 1642-1647
- 20 Evaluation of hemoptysis - Differential diagnosis of symptoms | BMJ Best Practice US [Internet]. Accessed October 5, 2022 at: https://bestpractice.bmj.com/topics/en-us/1039
- 21 Larici AR, Franchi P, Occhipinti M. et al. Diagnosis and management of hemoptysis. Diagn Interv Radiol 2014; 20 (04) 299-309
- 22 Imaging findings as predictors of the site of bleeding in patients with hemoptysis: Comparison between split-bolus dual-energy CT angiography and digital subtraction angiography [Internet]. Accessed October 6, 2022 at: http://www.dirjournal.org/en/imaging-findings-as-predictors-of-the-site-of-bleeding-in-patients-with-hemoptysis-comparison-between-split-bolus-dual-energy-ct-angiography-and-digital-subtraction-angiography-132385
- 23 Meena P, Bhalla AS, Goyal A. et al. Single-phase split-bolus dual energy computed tomography angiography for evaluation of hemoptysis: a novel application. J Thorac Imaging 2018; 33 (06) 366-376
- 24 Marquis KM, Raptis CA, Rajput MZ. et al. CT for evaluation of hemoptysis. Radiographics 2021; 41 (03) 742-761
- 25 Kandathil A, Chamarthy M. Pulmonary vascular anatomy & anatomical variants. Cardiovasc Diagn Ther 2018; 8 (03) 201-207
- 26 Jerbi I souissi A Jemli, A Ben fatma, S Marouen, S. Pulmonary artery aneurysms and pseudo aneurysms: a rare but potentially fatal finding [Internet]. ECR 2022 EPOS. European Congress of Radiology - ECR 2022; 2022. Accessed October 8, 2022 at: https://epos.myesr.org/poster/esr/ecr2022/C-14775
- 27 Ferretti GR, Thony F, Link KM. et al. False aneurysm of the pulmonary artery induced by a Swan-Ganz catheter: clinical presentation and radiologic management. AJR Am J Roentgenol 1996; 167 (04) 941-945
- 28 Shin S, Shin TB, Choi H. et al. Peripheral pulmonary arterial pseudoaneurysms: therapeutic implications of endovascular treatment and angiographic classifications. Radiology 2010; 256 (02) 656-664
- 29 Chatterjee K, Colaco B, Colaco C, Hellman M, Meena N. Rasmussen's aneurysm: a forgotten scourge. Respir Med Case Rep 2015; 16: 74-76
- 30 Irodi A, Keshava SN. Rasmussen's aneurysm – undue importance to an uncommon entity?. Br J Radiol 2009; 82 (980) 698
- 31 Santelli ED, Katz DS, Goldschmidt AM, Thomas HA. Embolization of multiple Rasmussen aneurysms as a treatment of hemoptysis. Radiology 1994; 193 (02) 396-398
- 32 Pruthi H, Muthu V, Bhujade H. et al. Pulmonary artery pseudoaneurysm in COVID-19-associated pulmonary mucormycosis: case series and systematic review of the literature. Mycopathologia 2022; 187 (01) 31-37
- 33 Santhosh Babu KBM, Kumar Muthukumar M, Vinu Moses M. et al. Role of endovascular interventions in the management of COVID-19 patients presenting with massive hemorrhage: a single-center experience. Vasc Dis Manag 2022; 19 (08) 3-5
- 34 Erkan F, Gül A, Tasali E. Pulmonary manifestations of Behçet's disease. Thorax 2001; 56 (07) 572-578
- 35 Martinez-Pitre PJ, Khan YS. Pulmonary Arteriovenous Malformation (AVMs). In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2022
- 36 Mondoni M, Carlucci P, Cipolla G. et al. Bronchoscopy to assess patients with hemoptysis: which is the optimal timing?. BMC Pulm Med 2019; 19 (01) 36
- 37 Mehta AK, Chamyal PC. Haemoptysis - indications for bronchoscopy. Med J Armed Forces India 1994; 50 (02) 123-125
- 38 Kathuria H, Hollingsworth HM, Vilvendhan R, Reardon C. Management of life-threatening hemoptysis. J Intensive Care 2020; 8 (01) 23
- 39 Parrot A, Tavolaro S, Voiriot G. et al. Management of severe hemoptysis. Expert Rev Respir Med 2018; 12 (10) 817-829
- 40 Goyal A, Khan IA, Kumar A. et al. Chest-wall collateral embolization to reduce surgical blood loss in peripheral aspergillomas. Thorac Cardiovasc Surg 2022; 70 (07) 589-595
- 41 Park SJ, Lee S, Lee HN, Cho Y. Early versus delayed bronchial artery embolization for non-massive hemoptysis. Eur Radiol 2023; 33 (01) 116-124
- 42 Shera TA, Bhalla AS, Naranje P. et al. Role of computed tomography angiography in the evaluation of haemoptysis in children: decoding the abnormal vessels. Indian J Med Res 2022; 155 (3&4): 356-363
- 43 Bhalla A, Kandasamy D, Veedu P, Mohan A, Gamanagatti S. A retrospective analysis of 334 cases of hemoptysis treated by bronchial artery embolization. Oman Med J 2015; 30 (02) 119-128
- 44 Agmy GM, Wafy SM, Mohamed SAA, Gad YA, Mustafa H, Abd El-Aziz AES. Bronchial and nonbronchial systemic artery embolization in management of hemoptysis: experience with 348 patients. Int Sch Res Notices 2013; 26: e263259
- 45 Lee Y, Lee M, Hur S. et al. Bronchial and non-bronchial systemic artery embolization with transradial access in patients with hemoptysis. Diagn Interv Radiol 2022; 28 (04) 359-363
- 46 Almeida J, Leal C, Figueiredo L. Evaluation of the bronchial arteries: normal findings, hypertrophy and embolization in patients with hemoptysis. Insights Imaging 2020; 11 (01) 70
- 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
- 48 Shin BS, Jeon GS, Lee SA, Park MH. Bronchial artery embolisation for the management of haemoptysis in patients with pulmonary tuberculosis. Int J Tuberc Lung Dis 2011; 15 (08) 1093-1098
- 49 Befera NT, Ronald J, Kim CY, Smith TP. Spinal arterial blood supply does not arise from the bronchial arteries: a detailed analysis of angiographic studies performed for hemoptysis. J Vasc Interv Radiol 2019; 30 (11) 1736-1742
- 50 Mattay RR, Shlansky-Goldberg R, Pukenas BA. Recurrent massive hemoptysis in a patient with cystic fibrosis: balloon assisted Onyx embolization after bronchial artery coil recanalization. CVIR Endovasc 2021; 4 (01) 4
- 51 Hahn S, Kim YJ, Kwon W, Cha SW, Lee WY. Comparison of the effectiveness of embolic agents for bronchial artery embolization: gelfoam versus polyvinyl alcohol. Korean J Radiol 2010; 11 (05) 542-546
- 52 Kucukay F, Topcuoglu OM, Alpar A, Altay ÇM, 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
- 53 van den Berg JC. Bronchial artery embolization. In: Vascular Embolotherapy. Berlin: Springer; 2006: 263-277
- 54 Khalil A, Fedida B, Parrot A, Haddad S, Fartoukh M, Carette MF. Severe hemoptysis: from diagnosis to embolization. Diagn Interv Imaging 2015; 96 (7-8): 775-788
- 55 Corr PD. Bronchial artery embolization for life-threatening hemoptysis using tris-acryl microspheres: short-term result. Cardiovasc Intervent Radiol 2005; 28 (04) 439-441
- 56 Monroe EJ, Pierce DB, Ingraham CR, Johnson GE, Shivaram GM, Valji K. An interventionalist's guide to hemoptysis in cystic fibrosis. Radiographics 2018; 38 (02) 624-641
- 57 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
- 58 McPherson S. Bronchial artery embolization. In: Kessel D, Ray C. eds. Transcatheter Embolization and Therapy [Internet]. London: Springer; 2009: 349-361
- 59 Ishikawa H, Hara M, Ryuge M. et al. Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study. BMJ Open 2017; 7 (02) e014805
- 60 Ryuge M, Hara M, Hiroe T. et al. Mechanisms of recurrent haemoptysis after super-selective bronchial artery coil embolisation: a single-centre retrospective observational study. Eur Radiol 2019; 29 (02) 707-715
- 61 Frood R, Karthik S, Mirsadraee S, Clifton I, Flood K, McPherson SJ. Bronchial artery embolisation for massive haemoptysis: immediate and long-term outcomes-a retrospective study. Pulm Ther 2020; 6 (01) 107-117
- 62 ACR Manual on Contrast Media. Version 10.1. Reston, VA: American College of Radiology; 2015
- 63 Aoun J, Nicolas D, Brown JR, Jaber BL. Maximum allowable contrast dose and prevention of acute kidney injury following cardiovascular procedures. Curr Opin Nephrol Hypertens 2018; 27 (02) 121-129
- 64 Alex A, Ayyappan A, Valakkada J, Kramadhari H, Sasikumar D, Menon S. Major aortopulmonary collateral arteries. Radiol Cardiothorac Imaging 2022; 4 (01) e210157
- 65 Kang MK, Kang DK, Hwang YH. Isolated unilateral pulmonary artery agenesis presenting with massive hemoptysis. Respirol Case Rep 2019; 8 (02) e00511
- 66 Bhalla AS, Gupta P, Mukund A, Kabra SK, Kumar A. Pulmonary artery narrowing: a less known cause for massive hemoptysis. Oman Med J 2013; 28 (02) e044
- 67 Stroke and myocardial infarction following bronchial artery embolization in a cystic fibrosis patient - PubMed [Internet]. Accessed October 8, 2022 at: https://pubmed.ncbi.nlm.nih.gov/27939048/
- 68 Fartoukh M, Khoshnood B, Parrot A. et al. Early prediction of in-hospital mortality of patients with hemoptysis: an approach to defining severe hemoptysis. Respiration 2012; 83 (02) 106-114
- 69 Ong TH, Eng P. Massive hemoptysis requiring intensive care. Intensive Care Med 2003; 29 (02) 317-320
- 70 Ramakantan R, Bandekar VG, Gandhi MS, Aulakh BG, Deshmukh HL. Massive hemoptysis due to pulmonary tuberculosis: control with bronchial artery embolization. Radiology 1996; 200 (03) 691-694
- 71 Chan VL, So LKY, Lam JYM. et al. Major haemoptysis in Hong Kong: aetiologies, angiographic findings and outcomes of bronchial artery embolisation. Int J Tuberc Lung Dis 2009; 13 (09) 1167-1173
- 72 Anuradha C, Shyamkumar NK, Vinu M, Babu NRSS, Christopher DJ. Outcomes of bronchial artery embolization for life-threatening hemoptysis due to tuberculosis and post-tuberculosis sequelae. Diagn Interv Radiol 2012; 18 (01) 96-101
- 73 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
- 74 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