Inferior Phrenic Arterial Embolization for Massive Hemoptysis of Tuberculosis
10.3969/j.issn.1005-5185.2015.11.002
- VernacularTitle:膈下动脉参与肺结核大咯血供血的介入栓塞研究
- Author:
Qiang LI
;
Haixian QU
;
Hu LIN
;
Zhiyuan TAN
;
Guokun AO
- Publication Type:Journal Article
- Keywords:
Tuberculosis,pulmonary;
Hemoptysis;
Embolization,therapeutic;
Inferior phrenic artery;
Angiography;
Radiography,interventional
- From:
Chinese Journal of Medical Imaging
2015;(11):804-807
- CountryChina
- Language:Chinese
-
Abstract:
Purpose Bronchial arterial embolization is the preferred hemostasis method for hemoptysis when medical treatment is invalid. This paper aims to discuss the safety and efficacy of inferior phrenic artery (IPA) embolization in the treatment of hemoptysis of tuberculosis when IPA is involved. Materials and Methods Twenty-eight patients who were confirmed that IPA got involved in the hemoptysis due to pulmonary tuberculosis by IPA angiography underwent embolization. CT scan was performed before the procedure and IPAs arteriography were performed during the interventional procedure. Once the blood supply was identified, catheterization and embolization was carried out with gelatin sponge particle, sodium polymannuronate microsphere or microcoil according to the patients' conditions. After the procedure, the IPA angiographic manifestations, clinical efficacy and complications were evaluated. Results Thirty-three IPAs were identified as getting involved in the blood supply in the 28 patients. Among those patients, 12 had left IPA involved, 11 had right IPA involved and the rest 5 had IPAs involved in both sides. The selective IPA angiography showed IPAs had enlargement, with numberous and disordered branches and hypervascularity. IPA-pulmonary artery shunt was found in 22 cases. None of the cases was found extravasation of contrast medium. The hemoptysis reoccurred in 4 patients on the second day, sixth day and 6 months after the first embolization, thus the procedures were performed three times in 1 patient and twice in the other 3 patients. Nine patients had fever as complication, 19 patients had chest pain and 5 suffered from mild dyspnea. These complications usually disappeared in 3-7 days after symptomatic treatment. Conclusion IPA embolization is technically feasible and safe, whose complications are likely to be few and self-restrictive.
