Bronchial artery embolisation in management of haemoptysis

The use of thoracic arterial embolotherapy for control of massive haemoptysis has been proven successful by hundreds of case reports. Use of more permanent occlusive materials in the future may prompt the use of transcatheter embolisation as the first-line treatment in patients with haemoptysis. Certainly, this procedure has many advantages over surgical intervention, including percutaneous approach, use of local anaesthesia, shorter hospitalization, earlier and easier ambulation as well as described morbidity and expense. Although it would be unwise to suggest that all patients with massive haemoptysis be treated with bronchial artery embolisation, it is also unwise and simply impossible to suggest that all patients with massive haemoptysis be treated surgically. The technique of bronchial artery embolisation has reached a state where it is currently considered the first line treatment for patients with haemoptysis of systemic origin who are poor surgical candidates. A combined effort utilising the skills of the interventional radiologists and thoracic surgeon offers the most prudent approach to the patient with massive haemoptysis.