Interventionelle Radiologie Scan 2015; 03(02): 155-167
DOI: 10.1055/s-0034-1392020
Fortbildung
© Georg Thieme Verlag KG Stuttgart · New York

Diagnostik und Therapie von Hämoptysen durch endovaskuläre Bronchialarterienembolisation

Harald Ittrich
,
Hans Klose
,
Marcel Simon
,
Gerhard Adam
Further Information

Publication History

Publication Date:
22 April 2015 (online)

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

  • 1 Haponik EF, Fein A, Chin R. Managing life-threatening hemoptysis: has anything really changed?. Chest 2000; 118: 1431-1435
  • 2 Marshall TJ, Jackson JE. Vascular intervention in the thorax: bronchial artery embolization for haemoptysis. Eur Radiol 1997; 7: 1221-1227
  • 3 Wholey MH, Chamorro HA, Rao G et al. Bronchial artery embolization for massive hemoptysis. JAMA 1976; 236: 2501-2504
  • 4 Uflacker R, Kaemmerer A, Picon PD et al. Bronchial artery embolization in the management of hemoptysis: technical aspects and long-term results. Radiology 1985; 157: 637-644
  • 5 Kato A, Kudo S, Matsumoto K et al. Bronchial artery embolization for hemoptysis due to benign diseases: immediate and long-term results. Cardiovasc Intervent Radiol 2000; 23: 351-357
  • 6 Jean-Baptiste E. Clinical assessment and management of massive hemoptysis. Crit Care Med 2000; 28: 1642-1647
  • 7 Cauldwell EW, Siekert RG et al. The bronchial arteries; an anatomic study of 150 human cadavers. Surg Gynecol Obstet 1948; 86: 395-412
  • 8 Pump KK. Distribution of bronchial arteries in the human lung. Chest 1972; 62: 447-451
  • 9 Deffebach ME, Charan NB, Lakshminarayan S et al. The bronchial circulation. Small, but a vital attribute of the lung. Am Rev Respir Dis 1987; 135: 463-481
  • 10 Botenga AS. [Broncho-bronchial anastomosis. A selective angiographic study]. Ann Radiol (Paris) 1970; 13: 1-16
  • 11 Furuse M, Saito K, Kunieda E et al. Bronchial arteries: CT demonstration with arteriographic correlation. Radiology 1987; 162: 393-398
  • 12 Malik AB, Tracy SE. Bronchovascular adjustments after pulmonary embolism. J Appl Physiol Respir Environ Exerc Physiol 1980; 49: 476-481
  • 13 McDonald DM. Angiogenesis and remodeling of airway vasculature in chronic inflammation. Am J Respir Crit Care Med 2001; 164: 39-45
  • 14 Yoon W, Kim JK, Kim YH et al. Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review. Radiographics 2002; 22: 1395-1409
  • 15 Di Chiro G. Unintentional spinal cord arteriography: a warning. Radiology 1974; 112: 231-233
  • 16 Remy J, Arnaud A, Fardou H et al. Treatment of hemoptysis by embolization of bronchial arteries. Radiology 1977; 122: 33-37
  • 17 Ferris EJ. Pulmonary hemorrhage. Vascular evaluation and interventional therapy. Chest 1981; 80: 710-714
  • 18 Crocco JA, Rooney JJ, Fankushen DS et al. Massive hemoptysis. Arch Intern Med 1968; 121: 495-498
  • 19 Dweik RA, Stoller JK. Role of bronchoscopy in massive hemoptysis. Clin Chest Med 1999; 20: 89-105
  • 20 Hsiao EI, Kirsch CM, Kagawa FT et al. Utility of fiberoptic bronchoscopy before bronchial artery embolization for massive hemoptysis. AJR Am J Roentgenol 2001; 177: 861-867
  • 21 Hirshberg B, Biran I, Glazer M et al. Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Chest 1997; 112: 440-444
  • 22 Baumueller S, Winklehner A, Karlo C et al. Low-dose CT of the lung: potential value of iterative reconstructions. Eur Radiol 2012; 22: 2597-2606
  • 23 Millar AB, Boothroyd AE, Edwards D et al. The role of computed tomography (CT) in the investigation of unexplained haemoptysis. Respir Med 1992; 86: 39-44
  • 24 Bruzzi JF, Remy-Jardin M, Delhaye D et al. Multi-detector row CT of hemoptysis. Radiographics 2006; 26: 3-22
  • 25 Remy-Jardin M, Bouaziz N, Dumont P et al. Bronchial and nonbronchial systemic arteries at multi-detector row CT angiography: comparison with conventional angiography. Radiology 2004; 233: 741-749
  • 26 Tak S, Ahluwalia G, Sharma SK et al. Haemoptysis in patients with a normal chest radiograph: bronchoscopy-CT correlation. Australas Radiol 1999; 43: 451-455
  • 27 Fernando HC, Stein M, Benfield JR et al. Role of bronchial artery embolization in the management of hemoptysis. Arch Surg 1998; 133: 862-866
  • 28 Garzon AA, Gourin A. Surgical management of massive hemoptysis. A ten-year experience. Ann Surg 1978; 187: 267-271
  • 29 Shigemura N, Wan IY, Yu SC et al. Multidisciplinary management of life-threatening massive hemoptysis: a 10-year experience. Ann Thorac Surg 2009; 87: 849-853
  • 30 Poyanli A, Acunas B, Rozanes I et al. Endovascular therapy in the management of moderate and massive haemoptysis. Br J Radiol 2007; 80: 331-336
  • 31 Schrodt JF, Becker GJ, Scott JA et al. Bronchial artery embolization: monitoring with somatosensory evoked potentials. Work in progress. Radiology 1987; 164: 135-139
  • 32 Vujic I, Pyle R, Hungerford GD et al. Angiography and therapeutic blockade in the control of hemoptysis. The importance of nonbronchial systemic arteries. Radiology 1982; 143: 19-23
  • 33 Fellows KE, Khaw KT, Schuster S et al. Bronchial artery embolization in cystic fibrosis; technique and long-term results. J Pediatr 1979; 95: 959-963
  • 34 Rabkin JE, Astafjev VI, Gothman LN et al. Transcatheter embolization in the management of pulmonary hemorrhage. Radiology 1987; 163: 361-365
  • 35 Remy J, Lemaitre L, Lafitte JJ et al. Massive hemoptysis of pulmonary arterial origin: diagnosis and treatment. AJR Am J Roentgenol 1984; 143: 963-969
  • 36 Sbano H, Mitchell AW, Ind PW et al. Peripheral pulmonary artery pseudoaneurysms and massive hemoptysis. AJR Am J Roentgenol 2005; 184: 1253-1259
  • 37 Picard C, Parrot A, Boussaud V et al. Massive hemoptysis due to Rasmussen aneurysm: detection with helicoidal CT angiography and successful steel coil embolization. Intensive Care Med 2003; 29: 1837-1839
  • 38 White Jr RI. Bronchial artery embolotherapy for control of acute hemoptysis: analysis of outcome. Chest 1999; 115: 912-915
  • 39 Corr PD. Bronchial artery embolization for life-threatening hemoptysis using tris-acryl microspheres: short-term result. Cardiovasc Intervent Radiol 2005; 28: 439-441
  • 40 Landwehr P, Arnold S, Voshage G et al. [Embolotherapy: principles and indications]. Der Radiologe 2008; 48: 73-95 quiz 96–77
  • 41 Medsinge A, Zajko A, Orons P et al. A case-based approach to common embolization agents used in vascular interventional radiology. AJR American journal of roentgenology 2014; 203: 699-708
  • 42 Sopko DR, Smith TP. Bronchial artery embolization for hemoptysis. Seminars in interventional radiology 2011; 28: 48-62
  • 43 Vaidya S, Tozer KR, Chen J. An overview of embolic agents. Seminars in interventional radiology 2008; 25: 204-215
  • 44 Boushy SF, Helgason AH, North LB. Occlusion of the bronchial arteries by glass microspheres. Am Rev Respir Dis 1971; 103: 249-263
  • 45 Naar CA, Soong J, Clore F et al. Control of massive hemoptysis by bronchial artery embolization with absolute alcohol. AJR Am J Roentgenol 1983; 140: 271-272
  • 46 Remy J, Smith M, Lemaitre L et al. Treatment of massive hemoptysis by occlusion of a Rasmussen aneurysm. AJR Am J Roentgenol 1980; 135: 605-606
  • 47 White RI Jr, Pollak JS, Wirth JA. Pulmonary arteriovenous malformations: diagnosis and transcatheter embolotherapy. J Vasc Interv Radiol 1996; 7: 787-804
  • 48 Pollak JS, Saluja S, Thabet A et al. Clinical and anatomic outcomes after embolotherapy of pulmonary arteriovenous malformations. J Vasc Interv Radiol 2006; 17: 35-44 quiz 45
  • 49 Razavi MK, Murphy K. Embolization of bronchial arteries with N-butyl cyanoacrylate for management of massive hemoptysis: a technical review. Techniques in vascular and interventional radiology 2007; 10: 276-282
  • 50 Baltacioglu F, Cimsit NC, Bostanci K et al. Transarterial microcatheter glue embolization of the bronchial artery for life-threatening hemoptysis: technical and clinical results. European journal of radiology 2010; 73: 380-384
  • 51 Yoo DH, Yoon CJ, Kang SG et al. Bronchial and nonbronchial systemic artery embolization in patients with major hemoptysis: safety and efficacy of N-butyl cyanoacrylate. AJR Am J Roentgenol 2011; 196: W199-W204
  • 52 Woo S, Yoon CJ, Chung JW et al. Bronchial artery embolization to control hemoptysis: comparison of N-butyl-2-cyanoacrylate and polyvinyl alcohol particles. Radiology 2013; 269: 594-602
  • 53 Ao M, Guo SL, Zhang XD et al. First case in China: Onyx for bronchial artery embolization in treatment of refractory massive hemoptysis in one case. Journal of thoracic disease 2013; 5: E98-E102
  • 54 Ramakantan R, Bandekar VG, Gandhi MS et al. Massive hemoptysis due to pulmonary tuberculosis: control with bronchial artery embolization. Radiology 1996; 200: 691-694
  • 55 Cohen AM, Doershuk CF, Stern RC. Bronchial artery embolization to control hemoptysis in cystic fibrosis. Radiology 1990; 175: 401-405
  • 56 Mal H, Rullon I, Mellot F et al. Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Chest 1999; 115: 996-1001
  • 57 Tanaka N, Yamakado K, Murashima S et al. Superselective bronchial artery embolization for hemoptysis with a coaxial microcatheter system. J Vasc Interv Radiol 1997; 8: 65-70
  • 58 Wong ML, Szkup P, Hopley MJ. Percutaneous embolotherapy for life-threatening hemoptysis. Chest 2002; 121: 95-102
  • 59 Katoh O, Kishikawa T, Yamada H et al. Recurrent bleeding after arterial embolization in patients with hemoptysis. Chest 1990; 97: 541-546
  • 60 Chun JY, Morgan R, Belli AM. Radiological management of hemoptysis: a comprehensive review of diagnostic imaging and bronchial arterial embolization. Cardiovasc Intervent Radiol 2010; 33: 240-250
  • 61 Hayakawa K, Tanaka F, Torizuka T et al. Bronchial artery embolization for hemoptysis: immediate and long-term results. Cardiovasc Intervent Radiol 1992; 15: 154-158 discussion 158–159
  • 62 Swanson KL, Johnson CM, Prakash UB et al. Bronchial artery embolization : experience with 54 patients. Chest 2002; 121: 789-795
  • 63 Lee S, Chan JW, Chan SC et al. Bronchial artery embolisation can be equally safe and effective in the management of chronic recurrent haemoptysis. Hong Kong medical journal = Xianggang yi xue za zhi/Hong Kong Academy of Medicine 2008; 14: 14-20
  • 64 Chun JY, Belli AM. Immediate and long-term outcomes of bronchial and non-bronchial systemic artery embolisation for the management of haemoptysis. Eur Radiol 2010; 20: 558-565
  • 65 Uflacker R, Kaemmerer A, Neves C et al. Management of massive hemoptysis by bronchial artery embolization. Radiology 1983; 146: 627-634
  • 66 Kim YG, Yoon HK, Ko GY et al. Long-term effect of bronchial artery embolization in Korean patients with haemoptysis. Respirology 2006; 11: 776-781
  • 67 Osaki S, Nakanishi Y, Wataya H et al. Prognosis of bronchial artery embolization in the management of hemoptysis. Respiration 2000; 67: 412-416