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Bronchial and Nonbronchial Systemic Artery Embolization for Life-threatening Hemoptysis: A Comprehensive Review¹

¹ From the Department of Diagnostic Radiology, Chonnam National University Hospital, Chonnam National University Medical School, 8 Hak-1-dong, Dong-gu, Gwangju 501-757, South Korea. Recipient of a Certificate of Merit award for an education exhibit at the 2001 RSNA scientific assembly. Received December 19, 2001; revision requested April 23, 2002; final revision received July 26; accepted August 1. Address correspondence to W.Y. (e-mail: radyoon@cnuh.com).

Massive hemoptysis is one of the most dreaded of all respiratory emergencies and can have a variety of underlying causes. In 90% of cases, the source of massive hemoptysis is the bronchial circulation. Diagnostic studies for massive hemoptysis include radiography, bronchoscopy, and computed tomography (CT) of the chest. Bronchoscopy and chest radiography have been considered the primary methods for the diagnosis and localization of hemoptysis. Many researchers currently suggest that CT should be performed prior to bronchoscopy in all cases of massive hemoptysis. Bronchial artery embolization (BAE) is a safe and effective nonsurgical treatment for patients with massive hemoptysis. However, nonbronchial systemic arteries can be a significant source of massive hemoptysis and a cause of recurrence after successful BAE. Knowledge of the bronchial artery anatomy, together with an understanding of the pathophysiologic features of massive hemoptysis, are essential for planning and performing BAE in affected patients. In addition, interventional radiologists should be familiar with the techniques, results, and possible complications of BAE and with the characteristics of the various embolic agents used in the procedure.

© RSNA, 2002

Index Terms: Arteries, bronchial, 943.1264, 943.92 • Arteries, therapeutic embolization, 943.1264 • Bronchi, anatomy, 671.92 • Bronchi, interventional procedures • Lung, CT, 60.1211, • Lung, hemorrhage • Pulmonary angiography, 60.124

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