Management of severe hemoptysis from pulmonary aspergilloma using endovascular embolization

Cardiovasc Intervent Radiol. 2006 Sep-Oct;29(5):807-10. doi: 10.1007/s00270-005-0329-0.

Abstract

Purpose: To determine the effectiveness of endovascular embolization as a temporizing measure in the management of severe hemoptysis caused by intracavitary pulmonary aspergilloma.

Methods: Patients presenting with hemoptysis, estimated to be more than 300 ml in the preceding 24 hr, in whom a radiological diagnosis of pulmonary aspergilloma was made on chest radiographs and/or computed tomography of the chest were subjected to bronchial and systemic arteriography and embolization using triacryl microspheres.

Results: Twelve patients with upper lobe intracavitary aspergillomas were managed with embolization. In 11 patients hemoptysis stopped within 24 hr and with no recurrence over the next 4 weeks. In 1 patient hemoptysis persisted and an upper lobe lobectomy was performed.

Conclusion: Embolization of bronchial and systemic arteries is an effective method for treating acute severe hemoptysis from intracavitary aspergillomas, allowing the patient time to recover for definitive surgical management.

MeSH terms

  • Acute Disease
  • Adult
  • Aspergillosis / complications*
  • Aspergillosis / diagnostic imaging
  • Bronchial Arteries
  • Bronchography
  • Embolization, Therapeutic*
  • Female
  • Hemoptysis / diagnostic imaging
  • Hemoptysis / etiology
  • Hemoptysis / therapy*
  • Humans
  • Lung / diagnostic imaging
  • Lung Diseases, Fungal / complications*
  • Lung Diseases, Fungal / diagnostic imaging
  • Male
  • Middle Aged
  • Radiography, Interventional
  • Thoracic Arteries
  • Tomography, X-Ray Computed