Medical Treatment for Hemoptysis

Abstract

Purpose : The purpose of this study was to evaluate bronchoscopic hemostasis and bronchial artery embolization (BAE) as treatments for patients with hemoptysis.
Methods : 138 patients (98 men and 40 women, ages 16-91) with hemoptysis were treated by use of bronchofiberscopy and BAE at our Department over the past 5 years. All patients underwent bronchofiberscopy within 48 hr of active bleeding to determine the bleeding site. The value of these medical treatment was evaluated.
Results : The causes of hemoptysis in these patients were bronchiectasis (82 cases), tuberculosis (12 cases), and lung cancer (12 cases). Bronchoscopic hemostasis was performed for 56 patients, and brought about desirable effects such as primary hemostasis. Indications for BAE were determined by the findings of bronchial arteriogram. BAE was performed for 49 patients, and brought about desirable effects such as hemostasis. About 50% of the patients had a relapse after bronchoscopic hemostasis. BAE resulted in an immediate cessation of hemoptysis in 46 of the initial 49 patients (93%). Long-term control of bleeding was achieved in 42 of the initial 49 patients (85%).
Conclusion : The principal treatment for hemoptysis is hemostasis and treatment of the underlying disease. Our study findings suggested that bronchoscopic hemostasis and BAE bring about desirable effects such as primary hemostasis. The effect of bronchoscopic hemostasis is only temporary, however and another treatment is required. The solid judgement of indication for bronchoscopic hemostasis and BAE is important to the success of hemostasis.