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At first, the site of bleeding was lateralized by flexible fiberoptic bronchoscopy and/or by radiograph. Under local anesthesia, transfemoral bronchial arteriography was performed percutaneously using 5F or 4F catheter, if possible after cessation of vasopressin therapy. When no abnormal bronchial arteries could be identified, nonbronchial systemic arteries were opacified. In all cases, bronchial or nonbronchial arteries were found to be abnormal with arterial enlargement, regions of hypervascularity, or systemic-to-pul-monic shunting. The embolization materials used were absorbable particles of gelatin sponge (Spongel; Houde Laboratories; Paris, France) (n = 19) or nonabsorbable particles of microspheres (Embospheres; Guerbet Laboratories; Louvres, France) (n = 16), dura mater (n = 11), polyvinyl alcohol (Ivalon; Ny-comed SA; Paris, France) (n = 6), andbucrylate (n = 3). Several types of embolization material were used in nine cases. Visualization of an anterior spinal branch or catheter instability were an absolute contraindication to the procedure. canadian family pharmacy

Our approach in ill patients with hemoptysis consists of transcatheter embolization of the bronchial arteries most likely responsible for causing the bleeding rather than an exhaustive search for all bronchial or nonbronchial arteries.
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