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大量咯血的紧急干预措施:挽救生命的血管内介入治疗的图文概述

Emergency interventions for massive haemoptysis: a pictorial overview of life-saving endovascular procedures.

作者信息

Samireddypalle Yugandhar, Arumulla Mithilesh, Rahul A, Karthickpriya P, Prudhvinath Reddy A, Damaraju Vikram, Ravindra Adimulam Ganga, Amitha Vikrama K S

机构信息

Department of Radiodiagnosis, All India Institute of Medical Sciences, Mangalagiri, Guntur, Andhra Pradesh, 522503, India.

Department of Pulmonary Medicine, All India Institute of Medical Sciences, Mangalagiri, Guntur, Andhra Pradesh, India.

出版信息

Emerg Radiol. 2025 Aug;32(4):635-644. doi: 10.1007/s10140-025-02361-2. Epub 2025 Jun 18.

Abstract

Massive haemoptysis is a medical emergency with high mortality if not promptly addressed. This pictorial essay aims to guide clinicians through the selection and execution of life-saving endovascular interventions tailored to the underlying vascular etiology. Emphasis is placed on clinical presentation, imaging clues, and procedural decision-making to enhance understanding among trainees and practicing radiologists. We present a curated series of cases of life-threatening haemoptysis managed with bronchial artery embolization (BAE), pulmonary artery embolization (PAE), embolization of acquired aortopulmonary collaterals (APCs), and thoracic endovascular aortic repair (TEVAR). Each case is dissected to highlight the clinical scenario, angiographic findings, interventional technique, and outcome. Endovascular management of haemoptysis should be guided by the underlying etiology and vascular anatomy. A structured approach to imaging interpretation, selective angiography, and tailored endovascular management can drastically reduce mortality. This educational overview bridges the gap between diagnosis and intervention, reinforcing practical decision-making in pulmonary vascular emergencies.

摘要

大量咯血是一种医疗急症,若不及时处理,死亡率很高。这篇图文并茂的文章旨在指导临床医生针对潜在的血管病因选择并实施挽救生命的血管内介入治疗。重点在于临床表现、影像学线索和程序决策,以增进实习医生和执业放射科医生的理解。我们展示了一系列经支气管动脉栓塞术(BAE)、肺动脉栓塞术(PAE)、后天性主肺动脉侧支血管(APC)栓塞术和胸主动脉腔内修复术(TEVAR)治疗的危及生命的咯血病例。对每个病例进行剖析,以突出临床情况、血管造影结果、介入技术和治疗效果。咯血的血管内治疗应根据潜在病因和血管解剖结构进行指导。一种结构化的影像解读、选择性血管造影和量身定制的血管内治疗方法可大幅降低死亡率。这一教育综述弥合了诊断与干预之间的差距,强化了肺血管急症中的实际决策。

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