Bronchial Artery Embolization
Endovascular management in bleeding states has established itself as a promising and effective treatment modality. Massive hemoptysis is one of the several hemorrhagic emergencies which has been successfully treated using bronchial artery embolization (BAE). Massive hemoptysis, defined as an expectoration of more than 300 ml of blood in a day, has a very high mortality when left untreated. The management of massive hemoptysis and recurrent non-massive hemoptysis (expectoration of > 100 ml of blood in a day for a few days or weeks) includes surgical and endovascular treatment. Though most of the patients with massive hemoptysis are not surgical candidates, but surgery remains the definitive treatment in some conditions (aspergilloma, hydatid cyst, thoracic vascular injuries). BAE in acute massive hemoptysis not only saves lives in emergency conditions but also bridges the time period before definitive elective surgical treatment can be undertaken in these conditions.