Pulmonary AVMs are rare pulmonary vascular malformations seen in the lungs. They have abnormal connections between the arteries and veins supplying the lungs. Patients with pulmonary AVM can develop hemoptysis, infections in the brain etc. If detected and symptomatic pulmonary AVMs can be treated by endovascular coil embolisation.
Bronchial artery embolization may be life saving in 80-90 % of patients with massive hemoptysis. However, its effect is palliative for symptom relief, the primary disease ( lung infection, lung cavity) needs to be treated by either by surgery or medication.
It is done by inserting small catheters (plastic tubes) in the blood vessel in the groin through a small pinhole incision. These catheters will be taken till the target blood vessel and the embolizing agent ( drug which can close the bleeding vessel) is injected into the bleeding blood vessel in the lung. Damage to the normal lung circulation is avoided during the procedure. The patient needs 6 hours of bed rest after the procedure. He can walk, do routine activities later.
Diseases of various organs can causing bleeding either by invading or involving the blood vessels themselves. Most of the times these episodes of bleeding are manageable by medication or local measures. However, some times if it is torrential, it may be life threatening and it may require an open surgery to close the blood vessel for controlling the bleeding. Embolization technique achieves the same purpose without an open surgery, by selectively closing the bleeding blood vessels through small tubes inserted through the thigh
|Symptoms||Site of bleeding||Source|
|Massive hemoptysis||Lungs||Bronchial/ pulmonary arteries|
|Postpartum Hemorrhage||Uterus||Uterine arteries|
|Epistaxis||Nose and nasopahrynx||External carotid branches/ internal carotid artery|
|Hematemesis||Upper gastrointestinal tract||Venous and arterial causes|
|Per rectal bleeding||Gastrointestinal tract||Arterial and venous causes|
|Hematuria||Kidney, rarely bladder||Renal arteries|
|Carotid blow out||Oral cavity, oropharynx||Oral cavity, oropharynx External carotid branches/ internal carotid artery|
Many of the emergency bleeding conditions can be treated by interventional radiology in a minimal invasive way. By passing small tubes and selectively cannulating the bleeding vessels, the interventional radiologist will be able to put closing materials (embolic agents) into the involved blood vessels, to close off the vessels. It is relatively safe, noninvasive does not require general anaesthesia and most importantly relatively quickly can be done in an unstable patient.
|Symptoms||Type of embolisation|
|Massive hemoptysis||Bronchial artery embolization|
|Postpartum Hemorrhage||Uterine artery embolization|
|Epistaxis||Internal maxillary embolization|
|Hematemesis||Selective arterial embolization for arterial bleeds TIPSS and BRTVO in variceal bleeds|
|Per rectal bleeding||Selective arterial embolization for arterial bleeds|
|Hematuria||Selective renal artery embolization|
|Carotid blow out||Exteranal carotid branch embolisation|
DR.SURESH GIRAGANI CONSULTANT INTERVENTIONAL RADIOLOGIST at Apollo Hospital, has more than Seventeen years of clinical experience in vascular interventions with a special interest in neurovascular and peripheral vascular disease interventional procedures.
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