Document Detail

Hemoptysis requiring bronchial artery embolization in pulmonary arterial hypertension.
MedLine Citation:
PMID:  20689485     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Hemoptysis is an uncommon complication in patients with pulmonary arterial hypertension (PAH). Although the mechanism of hemoptysis is unknown, treatment with bronchial artery embolization (BAE) is proposed to be a safe and reliable method of treatment. We report our experience in treating PAH patients presenting with acute hemoptysis that required multiple BAEs.
METHODS: Three female and one male PAH patients, ages 45 + or - 9 years (mean + or - standard deviation [SD]) presented with acute hemoptysis. Right ventricular systolic pressure and cardiac index at the time of the first episode of hemoptysis were 85 + or - 17 mm Hg and 2.7 + or - 0.7 L/min/m, respectively. Two of the four patients had recurrent episodes of hemoptysis, requiring multiple BAEs. All four were on intravenous prostacyclin analogue. None were receiving warfarin or endothelin receptor antagonists at the time of the episode. During each episode of hemoptysis, international normalized ratio (INR) was 1.09 + or - 0.11 units, and platelet count was 124,000 + or - 47,000 per microliter.
RESULTS: Each episode of hemoptysis was acutely terminated with BAE. In the majority of cases, patients had multiple aberrant bronchial arteries embolized, and an average of 2.3 arteries was embolized per session (1-4 embolized arteries). Each BAE was performed utilizing polyvinyl alcohol particles, ranging from 250-500 microns. There were no reported complications of the 14 BAE procedures performed.
CONCLUSION: Although the incidence of hemoptysis is unknown and likely underreported, we report our experience in which recurrent hemoptysis was treated with multiple BAE procedures. This report emphasizes the efficacy and safety of BAE in terminating episodes of recurrent hemoptysis in patients with severe PAH.
Jose A Cantu; Zeenat Safdar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Southern medical journal     Volume:  103     ISSN:  1541-8243     ISO Abbreviation:  South. Med. J.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-09-28     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  0404522     Medline TA:  South Med J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  887-91     Citation Subset:  AIM; IM    
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MeSH Terms
Bronchial Arteries*
Embolization, Therapeutic*
Hemoptysis / etiology*,  therapy*
Hypertension, Pulmonary / complications*
Middle Aged
Polyvinyl Alcohol
Retrospective Studies
Grant Support
Reg. No./Substance:
9002-89-5/Polyvinyl Alcohol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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