The author's purpose was to evaluate the efficacy of
therapeutic embolization in pulmonary
hemorrhage performed with
fibrin foam (
Spongostan) suspended in
sclerosing agents (hydroxy-polyethoxy-
dodecane 3%, or natrium morruate 5%), and
electrocoagulation (
Biotrol, spa) as an alternative to surgery. Twenty patients were embolized: 17 with
fibrin foam and
sclerosing agents only, 2 with the addition of
electrocoagulation and a Gianturco coil respectively, and 1 with
electrocoagulation alone. The follow-up ranges from 3 to 42 months (average 22). A patient affected by aspergilloma died a few days after
hemoptysis. The patient treated by
electrocoagulation alone suffers from periodical hematic expectoration (spitting). The remaining 18 patients have not shown any pathological findings. In 2 cases the
arterial occlusion was confirmed by angiography, while in 1 case partial arterial recanalization was observed. Such a finding was due to the vessel dimensions and to hyperflux values. In similar cases, obstruction must be completed by different techniques (e.g. Gianturco coils,
electrocoagulation, detachable balloons, etc.). The absence of flux resulting from embolization improves
electrocoagulation efficiency, which should be considered as the technique of choice. Even though additional trials are needed, the techniques have proven quite reliable and suitable to replace surgery in low-aggression lesions.