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European Radiology 1997Massive haemoptysis is defined as the expectoration of more than 600 mls of blood in 48 h. Many patients are not surgical candidates because of the presence of severe... (Review)
Review
Massive haemoptysis is defined as the expectoration of more than 600 mls of blood in 48 h. Many patients are not surgical candidates because of the presence of severe bilateral pulmonary disease and these individuals are best managed by bronchial artery embolization. Occlusion of both the bronchial arteries and hypertrophied non-bronchial systemic arteries is essential if bleeding is to be controlled. A pulmonary arterial source of haemorrhage is uncommon but should always be considered in a patient who has further haemoptyses shortly after a technically successful embolization of bronchial and non-bronchial systemic arteries. The immediate control of haemorrhage is achieved in the majority of patients although subsequent rebleeding on longterm follow-up is not uncommon.
Topics: Bronchial Arteries; Embolization, Therapeutic; Hemoptysis; Humans; Pulmonary Artery; Radiography, Interventional
PubMed: 9377505
DOI: 10.1007/s003300050279 -
Grudnaia Khirurgiia (Moscow, Russia) 1981
Review
Topics: Bronchial Arteries; Heart Defects, Congenital; Hemorrhage; Humans; Ligation; Lung Diseases
PubMed: 7037561
DOI: No ID Found -
Annals of Cardiac Anaesthesia 2021Massive pulmonary hemorrhage during pulmonary thromboendarterectomy (PTE) can be managed by a conservative approach with mechanical ventilatory support, positive...
Massive pulmonary hemorrhage during pulmonary thromboendarterectomy (PTE) can be managed by a conservative approach with mechanical ventilatory support, positive end-expiratory pressure, lung isolation, reversal of heparin, and correct of coagulopathy. We present three challenging cases that developed intrapulmonary hemorrhage during/after PTE and managed successfully. The first patient had bleeding from the bronchial artery and right internal mammary collaterals, which was managed by coil-embolization. The second patient had a breach in the blood airway barrier in the right upper lobar segment of the lung, and the repair was done using a surgical absorbable hemostat. The third patient developed reperfusion injury, he was instituted on veno-venous extracorporeal membranous oxygenation, a week later, the patient recovered completely. An algorithm was adopted and modified to our requirements; all the 3 challenging intrapulmonary hemorrhage cases were successfully managed. This algorithm can be used for satisfactory outcomes in patients who suffer intrapulmonary hemorrhage during PTE.
Topics: Chronic Disease; Endarterectomy; Hemorrhage; Humans; Hypertension, Pulmonary; Infant, Newborn; Lung; Male; Pulmonary Artery; Pulmonary Embolism
PubMed: 34269276
DOI: 10.4103/aca.ACA_191_20 -
Archivos de Bronconeumologia Feb 2021
Topics: Aneurysm, False; Bronchial Arteries; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Hematoma; Humans; Mediastinal Diseases
PubMed: 32829998
DOI: 10.1016/j.arbres.2020.07.018 -
Revue Des Maladies Respiratoires Apr 2024In France, even though it occurs only exceptionally in cases of hemopathy, severe hemoptysis in cancer is the leading cause of hemoptysis. Without adequate treatment,... (Review)
Review
In France, even though it occurs only exceptionally in cases of hemopathy, severe hemoptysis in cancer is the leading cause of hemoptysis. Without adequate treatment, in-hospital mortality exceeds 60%, even reaching 100% at 6 months. The management of severe hemoptysis should be discussed with the oncologist. Aside from situations of threatening hemoptysis, in which bronchoscopy should be performed immediately, CT angiography is an essential means of localizing the bleeding and determining the causes and the vascular mechanisms involved. In more than 90% of cases, hemoptysis is linked to systemic bronchial or non-bronchial hypervascularization, whereas in fewer than 5%, it is associated with pulmonary arterial origin or, exceptionally, with damage to the alveolar-capillary barrier. The most severely ill patients must be treated in intensive care in centers equipped with interventional radiology, thoracic surgery and, ideally, with interventional bronchoscopy. Interventional radiology is the first-line symptomatic treatment. In over 80% of cases, bronchial arteriography with embolization allows immediate control. Emergency surgery should be avoided, as it is associated with significant mortality. Appropriate and adequate care reduces hospital mortality to 30%, enabling patients to benefit from the most recent, survival-prolonging treatments.
Topics: Humans; Hemoptysis; Embolization, Therapeutic; Bronchoscopy; Bronchi; Hematology
PubMed: 38155073
DOI: 10.1016/j.rmr.2023.11.004 -
Journal of Vascular Surgery Nov 2009
Topics: Acute Disease; Aortic Diseases; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Bronchial Fistula; Emergency Treatment; Esophageal Fistula; Hematemesis; Hemoptysis; Hemostatic Techniques; Hospital Mortality; Humans; Reoperation; Shock, Hemorrhagic; Stents; Time Factors; Treatment Outcome; Vascular Fistula
PubMed: 19878782
DOI: 10.1016/j.jvs.2009.09.001 -
Annals of the American Thoracic Society Jul 2015
Topics: Adult; Atrial Fibrillation; Bronchi; Cryosurgery; Hematoma; Hemoptysis; Humans; Male; Postoperative Complications; Treatment Outcome
PubMed: 26203613
DOI: 10.1513/AnnalsATS.201503-135LE -
Internal Medicine (Tokyo, Japan) 2013Diffuse alveolar haemorrhage (DAH) is a serious complication of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). A literature review was... (Review)
Review
Diffuse alveolar haemorrhage (DAH) is a serious complication of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). A literature review was performed to ascertain the diagnostic features, treatment, and outcome of this rare but serious condition. Haemoptysis and dyspnoea are common but non-specific features. Chest radiography is usually abnormal, and high-resolution computerised tomographic scanning is more sensitive. Increased uptake of inhaled carbon monoxide and reduced clearance of C(15)O on lung function testing is suggestive of intra-alveolar blood. Fiberoptic bronchoscopy and bronchoalveolar lavage are useful when a super-added infection is suspected. Concurrent renal disease is common and contributes to the morbidity and mortality. Treatment should be individualised, and it is based on glucocorticoid and cyclophosphamide induction with azathioprine maintenance. The role of plasmapheresis is unclear, and is currently being evaluated. Patients are at risk of disease and treatment-related long-term complications. Ongoing research into the most efficacious therapeutic regimens associated with the least side effects is especially important.
Topics: Adrenal Cortex Hormones; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Bronchial Diseases; Cause of Death; Combined Modality Therapy; Disease Progression; Female; Hemoptysis; Hemorrhage; Humans; Male; Plasmapheresis; Prognosis; Pulmonary Alveoli; Recurrence; Risk Assessment; Severity of Illness Index; Survival Rate
PubMed: 23291668
DOI: 10.2169/internalmedicine.52.8863 -
Radiographics : a Review Publication of... 2006Hemoptysis is symptomatic of a potentially life-threatening condition and warrants urgent and comprehensive evaluation of the lung parenchyma, airways, and thoracic... (Review)
Review
Hemoptysis is symptomatic of a potentially life-threatening condition and warrants urgent and comprehensive evaluation of the lung parenchyma, airways, and thoracic vasculature. Multi-detector row computed tomographic (CT) angiography is a very useful noninvasive imaging modality for initial assessment of hemoptysis. The combined use of thin-section axial scans and more complex reformatted images allows clear depiction of the origins and trajectories of abnormally dilated systemic arteries that may be the source of hemorrhage and that may require embolization. Conditions such as bronchiectasis, chronic bronchitis, lung malignancy, tuberculosis, and chronic fungal infection are some of the most common underlying causes of hemoptysis and are easily detected with CT. "Cryptogenic" hemoptysis is common among smokers and warrants subsequent follow-up imaging to exclude possible underlying malignancy. The bronchial arteries are the source of bleeding in most cases of hemoptysis. Contributions from the non-bronchial systemic arterial system represent an important cause of recurrent hemoptysis following apparently successful bronchial artery embolization. Vascular anomalies such as pulmonary arteriovenous malformations and bronchial artery aneurysms are other important causes of hemoptysis. Multi-detector row CT angiography permits noninvasive, rapid, and accurate assessment of the cause and consequences of hemorrhage into the airways and helps guide subsequent management.
Topics: Acute Disease; Adult; Angiography; Bronchi; Hemoptysis; Humans; Lung; Middle Aged; Tomography, X-Ray Computed
PubMed: 16418239
DOI: 10.1148/rg.261045726 -
Revue Medicale de Liege Jan 2012Hemoptysis is defined by the expectoration of blood from infra-glottal airway. Massive hemoptysis can be a life-threatening intrathoracic disease that requires urgent... (Review)
Review
Hemoptysis is defined by the expectoration of blood from infra-glottal airway. Massive hemoptysis can be a life-threatening intrathoracic disease that requires urgent investigations and management. The chest radiography and the computed tomography (CT) are useful to localize the bleeding site and to identify the cause of hemoptysis. Bronchial artery embolization is the most effective nonsurgical treatment in the management of massive and recurrent hemoptysis. This article reviews the role of radiology in the diagnosis and treatment of hemoptysis.
Topics: Bronchial Arteries; Diagnosis, Differential; Embolization, Therapeutic; Hemoptysis; Humans; Ligation; Models, Biological; Radiography, Thoracic
PubMed: 22420099
DOI: No ID Found