Angiographic Findings and Outcomes of Bronchial Artery Embolization for Hemoptysis Due to Tuberculosis

Background: Hemoptysis is a common, important and sometimes life-threatening symptom. The causes of hemoptysis vary significantly between the developed and non-developed countries. In non-developed countries, tuberculosis remains the most frequent cause of massive hemoptysis. Management of hemoptysis include conservative treatment, surgery and bronchial artery embolization (BAE). Since Remy et al. first described BAE for the management of hemoptysis, several studies have declared the efficacy of BAE in tuberculosis patients. The aim of this study was to evaluate angiographic findings during BAE in tuberculosis patients and to compare them with non-tuberculosis patients. Method(s): Patients who underwent BAE between August 2015 and July 2018 in a single interventional radiology department with hemoptysis refractory to medical and bronchoscopic treatment were reviewed. A total of 89 patients (66 male and 23 female; mean age 52.71 ± 15.37) were incorporated in the study. Patients were divided into two groups: tuberculosis group (n = 36) and non-tuberculosis group (16 malignancy, 22 bronchiectasis, 6 pulmonary infection, 4 chronic obstructive pulmonary disease, 4 idiopathic, 1 pulmonary arteriovenous malformation; n = 53). Angiography and embolization procedure were performed by a 5-year, 10-year, and 20-year experienced interventional radiologists with a classical method. Angiographic findings were classified as tortuosity, hypertrophy, hypervascularity, aneurysm, bronchopulmonary shunt, extravasation, and normal bronchial artery. Chi square test was used to compare angiographic findings between tuberculosis and non-tuberculosis patient group. Result(s): The most common angiographic findings in tuberculosis patients were tortuosity (%97.2) as well as hypervascularity (%97.2). Extravasation was seen in only one patient (%2.7). Bronchopulmonary shunt was found significantly higher in tuberculosis patients compared to non-tuberculosis group (p = 0.002). None of the groups showed statistically significant difference in respect to recurrence (p = 0.436). Conclusion(s): BAE is a useful and effective treatment method of hemoptysis in tuberculosis. Bronchopulmonary shunt was seemed to be significantly higher in tuberculosis patients.

Publication History

Article published online:
11 May 2021