Study on arterial embolization for massive hemoptysis due to pulmonary tuberculosis when proper esophageal artery participates in blood supply

doi:10.3969/j.issn.1000-6621.2021.07.009

Abstract

Abstract: Objective To explore the safety and efficacy of proper esophageal artery (PEA) embolization in the treatment of massive hemoptysis due to pulmonary tuberculosis when PEA participates in blood supply, as well as the characteristics of lesions. Methods Clinical data of 11 patients confirmed that PEA participate in blood supply for the massive hemoptysis due to pulmonary tuberculosis by PEA angiography from the 8th Medical Center of Chinese PLA General Hospital between June 2017 and July 2020 were analyzed. CT scan was performed before the procedure and PEA arteriography were performed during the interventional procedure. Once the blood supply was identified, catheterization and embolization were selectively inserted into the main artery for embolization with PVA particle. The distribution and characteristics of the lesions, angiographic findings and treatment results were analyzed. Results All the 11 patients were complicated with thickening of the left mediastinal pleura. The damaged upper lobe of left lung was found in 3 patients, 7 patients were complicated with the bronchiectasis of left lower lobar, and the cavity of left lung was found in 5 patients. In 3 patients, the origin of PEA was on the level of T₆; in 8 patients, the origin of PEA was on the level of T_7-8. Enlargement of trunk, increase and disorder of branches, as well as neovascularization were found in angiography. PEA-pulmonary artery shunt was found in 5 patients. Communication between the esophageal artery and the left bronchial artery was observed in 1 patient, and between the esophageal artery and the right bronchial artery was observed in another patient. Hemoptysis stopped immediately after treatment in all the patients. Recurrent hemoptysis was observed in 3 patients 2 days, 22 months and 37 months after the treatment, respectively, which were considered to be unrelated to the PEA. There was no recanalization of the PEA. No serious complications were observed. Conclusion PEA participating in blood supply for tuberculosis lesion always occurred in patients complicated with thickening of the left mediastinal pleura, and lesions mainly located in the lower lobe and lingual lobe of left lung. PEA embolization is technically feasible and safe.

Key words: Tuberculosis, pulmonary, Hemoptysis, Embolization, therapeutic, Proper esophageal artery, Radiography, interventional

FENG Yan, LI Ying, LI Qiang, ZHANG Dan, LIN Hu, GUO Xian-li. Study on arterial embolization for massive hemoptysis due to pulmonary tuberculosis when proper esophageal artery participates in blood supply[J]. Chinese Journal of Antituberculosis, 2021, 43(7): 689-693. doi: 10.3969/j.issn.1000-6621.2021.07.009

Figures/Tables 1

References 17

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