Diagnostik und Therapie von Hämoptysen durch endovaskuläre Bronchialarterienembolisation

Zusammenfassung

Hämoptysen als Symptome einer schwerwiegenden pulmonalen Grunderkrankung sind ein lebensbedrohlicher pulmonaler Notfall und erfordern eine umgehende Diagnostik und Therapie. Das Thoraxröntgen, die Kontrastmittel-unterstütze Mehrschicht-Computertomographie und CT-Angiographie und die Bronchoskopie liefern wertvolle Informationen zur zugrundeliegenden pulmonalen Erkrankung, zur Seitenlokalisation, zur Gefäßanatomie der Bronchialarterien sowie zur Planung des interventionell-endovaskulären Eingriffs. Therapeutisch hat sich die endovaskuläre Bronchialarterienembolisation (BAE) als sichere und effektive Technik bewährt und ist Erstlinientherapie bei massiven und rekurrierenden Hämoptysen sowie im Vorfeld einer elektiven Operation. Rezidivierende Hämoptysen erfordern nach Abklärung möglicher extrabronchialer, systemisch- und pulmonalarterieller Blutungsquellen eine erneute BAE.

• Literatur

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