Bronchial artery embolization.

Massive hemoptysis is a life-threatening emergency. Chest radiograph, computed tomography, and bronchoscopy play a complementary role in diagnosing the underlying cause of hemorrhage and localizing the bleeding site. Bronchial artery embolization remains the primary and most effective method in controlling massive hemoptysis. Bronchial and nonbronchial systemic arteries are the main source of bleeding and are embolized with polyvinyl alcohol particles or gelatin sponge. Immediate cessation of bleeding occurs in more than 75% of patients; however, long-term recurrences are common in patients with progressive lung disease. Complications are infrequent except for a rare occurrence of spinal cord ischemia.