Case report
Bronchial Artery Embolization for Pulmonary Arterial Hypertension and Recurrent Hemoptysis?

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Embolization of bronchial collaterals has been suggested as a means of controlling the recurrence of hemoptysis in patients with pulmonary arterial hypertension. In conclusion, the investigators present a patient in which this procedure failed to prevent further episodes of hemoptysis and discuss whether this procedure should be offered routinely, given the lack of sufficient data to support this approach.

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Case Description

A 28-year-old man with chronic thromboembolic PAH secondary to antiphospholipid syndrome and a history of recurrent hemoptysis was referred for further investigation in our hospital. He was medically treated with bosentan, inhaled iloprost, night oxygen, and warfarin. On examination, the patient had signs of PAH, with a right ventricular heave and a loud pulmonary component of the second heart sound. Computed tomographic pulmonary angiography revealed 2 large bronchial arteries arising from the

Comments

We report a failure to prevent recurrent hemoptysis after elective embolization of the bronchial arteries in a patient with PAH. It was recently suggested that even patients with mild hemoptysis and chronic thromboembolic PAH should be offered prompt embolization of bronchial arteries as a treatment of choice.3 However, data on the long-term effects of catheter embolization on preventing hemoptysis in this group of patients are scarce. No randomized trials exist, and most case series reported

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