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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2011 October;170(5):383-6
Pulmonary artery embolization in a case of massive hemoptysis
Fossaceca R., Guzzardi G., Malatesta E., Di Terlizzi M., Martino F., Carriero A.
Istituto di Radiologia Diagnostica ed Interventistica, A.O.U. Maggiore della Carità, Novara, Italy
Hemoptysis from pulmonary artery is rarely seen in the clinical practice. Hereby the authors report a case of embolization in a bleeding from the posterior segment of the right superior pulmonary lobe in a 60 y.o. male. This patient was affected by an epithelial excavated carcinoma of the right lung which was treated by neo-adjuvant chemo and radiotherapy and he presented to the E.R. because of massive hemoptysis. Initially he was submitted to fibroptic-bronchoscopy that was unable to treat the bleeding because of severe respiratory insufficiency. After he was submitted successfully to selective embolization of the right upper lobe segmental artery with bleeding resolution. Patient was sent to ICU with PEEP and after 6 days transferred to ward. One day follow up CT scan demonstrated the occlusion of the right upper lobe arterial branch and diffuse post-hemorrhage parenchimal hyperdensity; six day follow up CT demonstrated resolution of parenchimal hyperdensity with some residual interstitial thickening. Patient clinical conditions progressively improved until he died, two months later, for cardiovascular complications. Endovascular emergency approach to massive hemoptysis is a feasible alternative treatment for patient with active severe bleeding.