Abstract
Background: Hemoptysis is sometimes a life threating condition and need to be treated urgently. Nearly 20% of hemoptysis cases were diagnosed as cryptogenic after clinical investigation.
Objective: The purpose of this study was to clarify clinical and angiographic characteristics of cryptogenic hemoptysis (CH).
Methods: We retrospectively reviewed medical records of 35 patients admitted to our hospital with CH from October 2010 to September 2014, who underwent bronchial artery embolization (BAE) using detachable coils.
Results: In the 35 cases, the angiographic findings revealed that the diameter of bronchial arteries was less than 2 mm in 13 patients (37.1%), 2 to 3 mm in 17 (48.5%) and more than 3 mm in five (14.2%). Hypervasculization was detected in 29 patients (82.9%), small bronchial aneurysms were detected in eight (22.9%), and systemic pulmonary shunt was in two (5.7%). The amount of hemoptysis was slight (< 50 mL/day) in 12, mild (50 - 100 mL/day) in 11, moderate (100 - 200 mL/day) in 8 and massive (> 200 mL/day) in four patients and no obvious relationship was found between the diameter of bronchial arteries and the amount of hemoptysis. Twentyeight cases (80.0%) had the history of smoking and 24 cases (68.7%) were current smokers. BAE was successfully performed in 33 patients (94.3%) while bronchoscopic hemostatic therapy was added in one patient (2.8%) and BAE was not done in one patient (2.8%) because the bronchial artery was too narrow. In successful embolization group, non-rebleeding rate was 100% for 12 months.
Conclusion: BAE was highly effective for the management of CH. Small bronchial aneurysms, undetected with CT angiography, were suspected as the cause in some cases.
- Copyright ©ERS 2015