RESUMEN
The recent epidemic of severe acute respiratory syndrome caught many by surprise. Hitherto, infection control has not been in the forefront of radiological practice. Many interventional radiology (IR) services are therefore not equipped to deal with such a disease. In this review, we share our experience from the interventional radiologist's perspective, report on the acute measures instituted within our departments and explore the long-term effects of such a disease on the practice of IR.
Asunto(s)
Control de Infecciones/organización & administración , Servicio de Radiología en Hospital/organización & administración , Síndrome Respiratorio Agudo Grave/transmisión , Humanos , Control de Infecciones/instrumentación , Equipos de Seguridad , Radiografía Intervencional/instrumentación , Síndrome Respiratorio Agudo Grave/diagnóstico por imagen , SingapurRESUMEN
PURPOSE: To review our method of embolization for hemoptysis. METHODS: Between 1993 and 1999, 134 patients were treated in our department for hemoptysis. One hundred and sixteen patients were followed up (18 were lost to follow-up) over a period ranging from 1 to 66 months (median 9.5 months, SD 14.81 months). Most cases were due to tuberculosis (83.6%) and malignancy (9.5%). One hundred and three required embolization. Vascular access was obtained via the femoral route but two cases required a brachial approach for abnormal branches of the subclavian artery. All abnormal vessels found were embolized using polyvinyl alcohol particles alone or in combination with gelfoam. RESULTS: Bronchial artery hypertrophy was found in 88.3% of cases; about a third of which had a nonbronchial systemic contribution. No angiographic abnormalities were found in 11.2%. Our failure rate was 18.4% (58% required surgery while 42% died from massive hemoptysis). Sixteen cases required multiple embolization sessions. No major complications were encountered. CONCLUSION: Embolization is effective for treatment of moderate to massive hemoptysis. The majority of our cases were due to tuberculosis. Approximately one third had nonbronchial systemic artery contributions, indicating that a concerted search for these is mandatory.