A Case with Repeating Acute Metabolic Acidosis after Therapeutic Bronchial Artery Embolization (BAE)

Abstract

A 68-year-old man was admitted because of massive hemoptysis due to non-tuberculous mycobacterial infection in the right lung. Angiographs showed vascular hyperplasia in the peripheral regions, of the right bronchial artery and lateral thoracic artery, which were extensively embolized. After BAE, he suffered repeated acute dyspnea with metabolic acidosis. Systemic hypercoagulopathy and vasoconstriction related to BAE seemed to trigger the condition. His cardiac hypofunction and systemic severe arteriosclerosis may clarify the pathogenesis. BAE has been established as an effective and safe procedure for the management of massive or recurrent hemoptysis. Our experience, however, suggests the importance of extensive evaluation of cardiac and vascular condition prior to BAE, especially when the procedure is to be performed in an aged patient.