Management of haemoptysis – online course
Please note that this course is no longer CME accredited.
Authors: M.Tsitskari and J. Vos
Reviewers: M. Das, F. Deschamps, M. Hoffmann, L. Kamper, S. Müller-Hülsbeck and C. Nice
This course corresponds to chapter 126.96.36.199.8 Visceral Arterial Disease in the European Curriculum and Syllabus for IR.
Haemoptysis is defined as the expectoration of blood from the lower airways. Although minor amounts of blood are coughed up in the vast majority of cases, massive amounts indicate a potentially life-threatening condition. It is almost always associated with chronic pulmonary disease and normally originates from the bronchial arteries. In cases requiring treatment, a CTA should be made if feasible, which will aid in treatment planning. The Bronchial Artery Embolisation (BAE) procedure is normally performed from a groin approach, using a 4 or 5 Fr sheath. Engaging the BA should be done with a 4 Fr catheter. If possible, a microcatheter should be placed in the BA in order to reduce the chance of spilling embolic material. If the right intercosto-bronchial trunk is treated, the microcatheter should be advanced well beyond the hairpin turn to avoid ischaemia of the thoracic wall in the territory of the first three intercostal arteries. Embolisation should always be done with particulate embolic material. Before embolisation material is inserted, a careful scrutiny of the angiograms for any sign of collateral filling into non-target organs should be performed. Specifically, any filling of the anterior spinal artery should be noted, as inadvertent embolisation of this vessel may lead to spinal cord ischaemia and paraplegia. Cessation of flow in all BA’s to the culprit region signifies technical success. Repeat embolisation may be necessary, especially if the underlying disease progresses; this carries a greater risk of complications, especially non-target embolisation.
- Main causes of haemoptysis
- Anatomy of the bronchial arteries
- Preprocedural work up of patients suffering from haemoptysis
- Indications and contraindications of bronchial artery embolisation (BAE)
- Basic techniques and pitfalls of BAE
- Potential complications of BAE
This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter 188.8.131.52.8 Visceral Arterial Disease.
The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one hour.
Access to complete and revisit the course is granted for an enrolment period of 90 days.
Release date: December 2019