الفهرس 
Contents
HemoptysisOnly 14 pages are availabe for public view
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Abstract
Background: Hemoptysis is bleeding that originates from the lower respiratory tract. Hemoptysis, when massive and untreated, has a mortality rate of 50%. In the majority of cases, the source of massive hemoptysis is the bronchial circulation. Chest MDCT permits a more sensitive, more rapid and accurate assessment of the cause hemorrhage. Since its introduction in 1973, BAE is now considered to be a first-line therapy to control massive hemoptysis, chronic recurrent mild and moderate hemoptysis. Clinical success immediately post-embolization is 73%-99% of patients. The most common complication of BAE is transient chest pain. Aim of work: The aim of this study was to assess the efficacy and safety of bronchial arterial angiography (MDCTA & catheter angiography) in detection of the source of hemoptysis and bronchial artery embolization for management of massive hemoptysis, recurrent mild or moderate hemoptysis. Methods: This study was carried out at Chest Medicine Department and Department of Diagnostic Radiology, Imaging and Intervention– Mansoura University Hospital (MUH), Mansoura, Egypt, in the period from August 2014 to August 2016. This study included 21 patients, 14 males, and 7 females. Age ranged from 27-75 years old, with mean age 51.71 years. All patients were subjected to the following: I) Full history taking as well as thorough clinical general and local chest examination, II) Laboratory investigations including; complete blood count, liver functions testing, serum creatinine, coagulation profile, virology markers, ESR, laboratory assessment of activity of tuberculosis, and ABG. III) Radiological investigations including plain chest X-ray, postero-anterior, and Multi-detector CT chest angiography. IV) Fiber-Optic bronchoscope. And V) Conventional bronchial arterial catheter angiography. Results: Post-TB complications (43%) and bronchiectasis (33%) were the most common causes of hemoptysis. CXR helped to detect the bleeding side in (71%) of patients, MDCT chest in (100%), FOB in (43%), and catheter angiography in (90%). There was no statistically significant difference in the clinical outcome among the two embolic agents that were used (regardless of particle size) immediately after the procedure, after one month, and even after 6months. Immediate success was achieved in (100%) of patients, while recurrence of hemoptysis was observed in (44%) of patients. Conclusion: Chest MDCTA is considered a primary non-invasive imaging modality in the evaluation of patients with hemoptysis. In experienced hands, BAE was effective to control both acute and chronic hemoptysis, with no serious complications. Risk factors for a recurrence included MDCT bilateral involvement, pre-embolization elevated CRP levels, and activity of the underlying etiology.