Bronchial artery embolic agents

Yoon W (2004) Embolic agents used for bronchial artery embolization in massive haemoptysis. Expert Opin Phar-macother 5 361-367... 

Bronchial artery embolization was first described in the literature in the 1970s by Remy [1], and over time it has become a well established treatment for patients with (massive) hemoptysis [2-5]. Technical improvements in both catheters and embolizing agents have attributed to the increase of the safety of the procedure and it s applicability. 

Various embolic agents can be employed for bronchial artery embolization, and include gelatin sponge, microspheres and coils. 

The most devastating complication is spinal cord ischemia, that has been reported to occur in 1.4%-6.5% of patients treated with bronchial artery embolization [9,30,39]. The occurrence of this complication can be reduced by using a superselective embolization technique, performing regular control angiograms before and after administration of embolic agents as has been described above. 

Thrombin injection into the bronchial artery has been described, and has a theoretical advantage in patients where tortuosity of the target artery precludes superselective catheterization [45]. However, given the rather unpredictable behavior, and risk of peripheral embolization, this agent has not gained wide acceptance, the same as using absolute alcohol as an embolic agent. 

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