ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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1/2020
vol. 85
 
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Chest radiology
abstract:
Original paper

Non-bronchial causes of haemoptysis: imaging and interventions

Manphool Singhal
1
,
Anupam Lal
1
,
Nidhi Prabhakar
1
,
Mukesh K. Yadav
1
,
Rajesh Vijayvergiya
2
,
Digamber Behra
3
,
Niranjan Khandelwal
1

1.
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India
2.
Department of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India
3.
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India
© Pol J Radiol 2020; 85: e328-e339
Online publish date: 2020/06/30
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Introduction
To describe non-bronchial causes of haemoptysis on imaging and the role of interventional radiology in their management from cases of haemoptysis archived from our database at a tertiary care, federally funded institution.

Material and methods
Retrospective analysis of cases that presented with haemoptysis in our institution from 2008 to 2013 was done, and details of cases in which the bleeding was from a non-bronchial source were archived and details of imaging and treatment were recorded.

Results
Retrospective analysis of patients presenting with haemoptysis yielded 24 (n = 24) patients having haemoptysis from non-bronchial sources. Causes of haemoptysis were: Rasmussen aneurysms (n = 12/24), costocervical trunk pseudoaneurysm (n = 1/24), left internal mammillary artery pseudoaneurysm (n = 1/24), left ventricular aneurysms (n = 3/24), pulmonary arteriovenous malformations (AVMs) (n = 5/24), and proximal interruption of pulmonary artery (n = 2/24). Imaging and interventional radiology management are described in detail.

Conclusions
Haemoptysis can be from non-bronchial sources, which may be either from systemic or pulmonary arteries or cardio-pulmonary fistulas. Bronchial computed tomography angiography (CTBA), if feasible, must always be considered before bronchial artery embolisation because it precisely identifies the source of haemorrhage and vascular anatomy that helps the interventional radiologist in pre-procedural planning. This circumvents chances of re-bleed if standard bronchial artery embolisation is done without CTBA.

keywords:

haemoptysis, non-bronchial causes, bronchial CT angiography, digital subtraction angiography, embolisation

 
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