scholarly journals Preemptive non-selective bronchial artery angioembolization to reduce recurrence rate of hemoptysis

2020 ◽  
Vol 15 ◽  
Author(s):  
Mohammad Sadegh Keshmiri ◽  
Shadi Shafaghi ◽  
Babak Sharif-Kashani ◽  
Ali Sadoughi ◽  
Fariba Ghorbani ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Lung Diseases ◽  
Bronchial Artery ◽  
Invasive Procedure ◽  
Massive Hemoptysis ◽  
Recurrent Bleeding ◽  
Bleeding Vessel ◽  
Threatening Condition ◽  
Life Threatening ◽  
One Year

Background: Massive hemoptysis which is presented in advanced lung diseases is a life-threatening condition. Bronchial artery embolization as a minimally invasive procedure is the treatment of choice either in first or recurrent hemoptysis. This study aimed to assess the early and late efficacy of bronchial angioembolization (BAE) without microcatheter.Methods: In this prospective cohort study, all patients with hemoptysis who had undergone BAE from August 2018 to March 2019 were included. Angiographic patterns including bleeding sources, number of involved vessels, the underlying etiology, and recurrence rate were evaluated in a one-year follow-up.Results: 153 patients were included with mean age of 55 ±16 years. 68% of them were male and 58% had life-threatening massive hemoptysis. Three distinct angiographic patterns were recognized. The culprit bleeding vessel was bronchial in 126 (92%), intercostal in 4 (3%), and both vessels in 7 (5%) of cases (P<0.05). One vessel involvement was seen in 56 patients; however it was observed in 69% of non-cystic fibrosis lobar bronchiectasis patients. In 1, 3 and 12 months follow up, recurrent hemoptysis was reported in 15 (11%), 4 (2.5%), and 24 (15.5%), respectively. In 52% of cases, no abnormal vessels were observed during aorta injection, but culprit bronchial or intercostal arteries were found in selective investigational angiography.Conclusion: BAE was successful in the control of hemoptysis and resulted in a low rate of recurrence in different types of lung diseases. This could be due to the embolization of all pathological arteries found during angiography which might have prevented recurrent bleeding.

Control of Tubercular Haemoptysis by Bronchial Artery Embolization

1997 ◽  
Vol 27 (3) ◽  
pp. 149-150 ◽  
Author(s):  
Sanjeev Mani ◽  
Rajesh Mayekar ◽  
Ravi Rananavare ◽  
Deepti Maniar ◽  
J Mathews Joseph ◽  
...  
Keyword(s):  
Bronchial Artery ◽  
Bronchial Artery Embolization ◽  
Artery Embolization ◽  
Selective Embolization ◽  
Bronchial Arteries ◽  
Bleeding Vessel ◽  
Life Threatening ◽  
Abnormal Bleeding ◽  
Recurrent Haemoptysis

Thirty-seven patients presenting with massive or recurrent haemoptysis secondary to tuberculous aetiology were subjected to bronchial artery angiography. Of these, failure to catheterize the bleeding vessel occurred in two patients while embolization was withheld in two patients due to the presence of anterior spinal artery arising from a common intercosto-bronchial trunk. Immediate arrest of bleeding was performed in the remaining 33 patients by selective embolization of the abnormal bronchial arteries with a resorbable material (Gelfoam). Regular follow up for a duration of 6 months after the procedure revealed relapse of haemoptysis in four patients; three were treated by re-embolization of the abnormal bleeding vessels while one patient died due to aspiration immediately on admission. No recurrence of bleeding was seen in the remaining 29 patients. It is concluded that bronchial artery embolization is an effective treatment for immediate control of life-threatening haemoptysis.

scholarly journals Successful treatment of pulmonary mucormycosis caused by Rhizopus microsporus with posaconazole

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
F. Yuan ◽  
J. Chen ◽  
F. Liu ◽  
Y. C. Dang ◽  
Q. T. Kong ◽  
...  
Keyword(s):  
Fungal Culture ◽  
Rhizopus Microsporus ◽  
Pulmonary Tissue ◽  
Case Presentation ◽  
Common Cause ◽  
Pulmonary Mucormycosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
One Year

Abstract Background Mucormycosis is a rare fungal infection occurring chiefly in the lung or the rhino-orbital-cerebral compartment, particularly in patients with immunodeficiency or diabetes mellitus. Among Mucorales fungi, Rhizopus spp. are the most common cause of mucormycosis. Case presentation We report a case of pulmonary mucormycosis caused by Rhizopus microsporus in a young patient with diabetes but no other apparent risk factors. The diagnosis mainly relied on clinical manifestation, positive pulmonary tissue biopsy, and fungal culture. The patient was successfully treated with posaconazole oral suspension and remains asymptomatic at one-year follow-up. Conclusions Pulmonary mucormycosis is a life-threatening condition and posaconazole is an effective treatment for pulmonary mucormycosis caused by Rhizopus microspores.

Life-Threatening Hemoptysis

2020 ◽  
Author(s):  
Himanshu Deshwal ◽  
Ankur Sinha ◽  
Atul C. Mehta
Keyword(s):  
Bronchial Artery ◽  
Vascular Anatomy ◽  
Massive Hemoptysis ◽  
Evidence Based ◽  
Airway Protection ◽  
Artery Embolization ◽  
Life Saving ◽  
Advanced Therapies ◽  
Life Threatening ◽  
And Control

AbstractLife-threatening hemoptysis (LTH) is any amount of hemoptysis that causes significant hemodynamic decompensation or respiratory distress which may lead to death if left untreated. While the amount of hemoptysis that qualifies as massive hemoptysis has continued to be debated, any amount between 100 to 1,000 mL/day is considered significant. Up to 15% cases of hemoptysis are LTH and need urgent life-saving intervention. Understanding of pulmonary vascular anatomy is of paramount importance to manage LTH. The goal of treatment lies in airway protection, appropriate oxygenation, and prevention of exsanguination. Once the airway is stabilized, a quick diagnosis and control of bleeding site is targeted. This chapter highlights current practices and approach to LTH including medical management, bronchoscopic approach, and advanced therapies such as bronchial artery embolization and surgical resection. We review situations, such as bronchiectasis, vascular malformation, diffuse alveolar hemorrhage, and tracheostomy bleed and specific approach to management of these conditions in a systematic and evidence-based manner.

scholarly journals Thoracic aortic aneurysm causing aorto-esophageal fistula—our experience with a rare disease

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Aakriti Yadav ◽  
Uttam Krishna Shrestha ◽  
Kajan Raj Shrestha ◽  
Dinesh Gurung
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Sudden Onset ◽  
Massive Hemoptysis ◽  
Esophageal Fistula ◽  
Feeding Jejunostomy ◽  
Intravenous Antibiotics ◽  
Threatening Condition ◽  
Life Threatening ◽  
Upper Gastrointestinal

Abstract Aorto-esophageal fistula is a life-threatening condition, accounting for a small number of cases of upper gastrointestinal bleeding where patients present with one or more features of Chiari’s triad. We present the case of a 43-year-old woman, referred to us with symptoms of central chest pain, sudden onset dysphagia followed by massive hemoptysis. She was diagnosed with an aorto-esophageal fistula due to a ruptured thoracic aortic aneurysm and rushed for an emergency endovascular thoracic aortic stent and feeding jejunostomy with intravenous antibiotics and supportive care. After 6 weeks of surgery, the patient was re-evaluated to plan for an esophageal stent if required. The purpose of this presentation is to make the surgical fraternity aware of the gravity of this disease and novel techniques to manage it.

scholarly journals Rasmussen’s Aneurysm, Rare yet Acknowledged Cause of Massive Hemoptysis: Retrospective Review of 16 Cases

2021 ◽  
Vol 36 (2) ◽  
pp. 136-143
Author(s):  
Seungwoo Chung ◽  
I Re Heo ◽  
Tae Hoon Kim ◽  
Sun Mi Ju ◽  
Jung-Wan Yoo ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Conservative Therapy ◽  
Bronchial Artery ◽  
Chest Ct ◽  
Massive Hemoptysis ◽  
Bronchial Artery Embolization ◽  
Artery Embolization ◽  
Chest Computed Tomography ◽  
Life Threatening ◽  
History Of

Objectives: Rasmussen’s aneurysm may cause life-threatening hemoptysis. We investigated the clinical characteristics and outcomes of patients with hemoptysis and Rasmussen’s aneurysm.Methods: We retrospectively investigated patients who clinically presented with hemoptysis and were diagnosed with a Rasmussen’s aneurysm on spiral chest computed tomography (CT).Results: Our study included 16 patients (men:women, 12:4; mean age, 65.25 ± 13.0 years). Massive hemoptysis was observed in nine patients (56%) and blood-tinged sputum in four patients (25%). Ten patients (62.5%) had a history of pulmonary tuberculosis, and three patients (18.7%) had underlying lung cancer. Chest CT revealed coexisting fungal balls in seven patients (43.7%). Bronchial artery embolization (BAE) was performed in 12 patients (75%). One patient died of uncontrolled massive hemoptysis.Conclusions: Patients with Rasmussen’s aneurysm showed hemoptysis during the course of the disease; however, bleeding can be controlled with conservative therapy and radiological interventions, such as BAE.

scholarly journals Massive Pulmonary Hemorrhage from Bronchial Varix

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Michael Agustin ◽  
Scott Shay ◽  
Jose Gonzalez ◽  
Pei Liu ◽  
Nancy Lentz ◽  
...  
Keyword(s):  
Bronchial Artery ◽  
Pulmonary Hemorrhage ◽  
Lung Ventilation ◽  
Massive Hemoptysis ◽  
Sleeve Resection ◽  
Artery Embolization ◽  
Blood Clots ◽  
Pulmonary Disorder ◽  
Life Threatening ◽  
Definitive Management

Bronchial varix is a rare pulmonary disorder which may lead to life-threatening hemorrhage. Diagnosis is difficult because of the subtle abnormalities on radiographic and bronchoscopic examination. We present a case of massive hemoptysis from a bleeding bronchial varix. In the absence of immediate complex endobronchial therapy in the island of Guam, this case was initially managed with nebulized and intravenous tranexamic acid. This was followed by endobronchial blockade of the bleeding airway with endobronchial epinephrine instillation. Selective bronchial artery embolization alleviated the acute-phase bleeding. Prone positioning was initiated due to severe hypoxia after blood clots compromised the patency of bilateral bronchial airways. Prone ventilation was employed for 17 hours for 2 consecutive days with intermittent bronchoscopic forceps extraction of airway blood clots while in the prone position. These maneuvers resulted to improved lung ventilation and oxygenation. The patient underwent bronchial sleeve resection surgery for definitive management.

Successful Treatment of Pulmonary Mucormycosis Caused by Rhizopus Microsporus With Posaconazole

2021 ◽  
Author(s):  
Fan Yuan ◽  
Jun Chen ◽  
Fang Liu ◽  
Yongchao Dang ◽  
Qingtao Kong ◽  
...  
Keyword(s):  
Fungal Culture ◽  
Rhizopus Microsporus ◽  
Pulmonary Tissue ◽  
Case Presentation ◽  
Common Cause ◽  
Pulmonary Mucormycosis ◽  
Threatening Condition ◽  
Life Threatening ◽  
One Year

Abstract Background: Mucormycosis is a rare fungal infection occurring chiefly in the lung or the rhino-orbital-cerebral compartment, particularly in patients with immunodeficiency or diabetes mellitus. Among Mucorales fungi, Rhizopus spp. are the most common cause of mucormycosis. Case presentation: We report the case of pulmonary mucormycosis caused by Rhizopus microsporus in a young patient with diabetes but no other apparent risk factors. The diagnosis has mainly relied on clinical manifestation, positive pulmonary tissue biopsy, and fungal culture. The patient was successfully treated with posaconazole oral suspension and remains asymptomatic at one-year follow-up.Conclusions: Pulmonary mucormycosis is a life-threatening condition and based on direct microscopy, histopathology, and culture for the diagnosis.

scholarly journals The Management of Near-Fatal Hemoptysis with Left Secondary Carinal Y Stent

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Levent Dalar ◽  
Cengiz Özdemir ◽  
Sinem Sökücü ◽  
Levent Karasulu ◽  
Sedat Altın
Keyword(s):  
Main Bronchus ◽  
Fiberoptic Bronchoscopy ◽  
Rigid Bronchoscopy ◽  
Left Main Bronchus ◽  
Massive Hemoptysis ◽  
Left Main ◽  
Threatening Condition ◽  
Life Threatening ◽  
Successful Control ◽  
Submucosal Infiltration

Massive hemoptysis can be a life threatening condition and needs urgent treatment in lung cancer. In the fiberoptic bronchoscopy of a fifty-two-year-old who was admitted with hemoptysis, left upper lobe upper division orifice was seen totally obstructed with a submucosal infiltration. One hour after the mucosal biopsies, massive hemoptysis occurred. Urgent rigid bronchoscopy was performed. The left main bronchus was occluded by sterile gauze. After cleaning of the coagulum patient was intubated and charged to intensive care unit. The next day, rigid bronchoscopy was repeated and the bleeding was observed to continue from the left upper lobe. Removing the gauze, 14 × 10 × 10 mm silicon Y stent was inserted in the left main bronchus after adjustments were made. Bleeding was stopped after insertion of the stent and patient could be extubated. In this case a successful control of hemoptysis was sustained after insertion of a customized silicon stent was presented.

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