The process of taking and digitizing bronchial embolization to erase the background
This article is professionally consulted by Master, Resident Doctor Tran Duc Tuan - Department of Diagnostic Imaging - Vinmec Central Park International General Hospital. The doctor has many years of experience in the field of imaging and interventional internal and external blood vessels.
Coronary angiography and embolization is a treatment technique used in patients with mild, moderate to severe hemoptysis and recurrence.
1. What are bronchi?
The human bronchus is anatomically an air duct in the lower respiratory system, located directly below the trachea, at the level of the 4-5 thoracic vertebrae. The bronchi are divided into small branches to carry air deep into the interior of the lungs and form the bronchial tree. Coughing up blood can have many causes, including the trachea and lungs. According to statistics, more than 90% of cases of coughing up blood, the cause of which comes from the lungs, is caused by damage to the bronchial artery branches. The procedure of bronchial embolization is one of the solutions given to improve that condition. .
2. What is bronchial embolism?
Bronchoalveolar embolization is actually a technique to visualize the arteries on a bright screen by injecting the contrast agent directly into the artery. Then, based on the image, to thread the specialized small tube into the artery, to the bronchi, to pump the emboli tablets into the damaged site to prevent coughing up blood in the patient.
3. When to do bronchial embolization
Bronchoalveolar embolization is indicated when the patient coughs up blood, or lightly coughs up a relatively small amount of blood but lasts for days and has not had a chance to have a radical surgery or the doctor has not indicated surgery. Bronchial embolization is absolutely contraindicated in patients with severe coagulopathy (prothrombin < 70%), platelets < 50 G/l. In cases where patients are allergic to contrast agents or have severe organ failure, bronchodilator embolization should also be considered.
4. Procedure for bronchial embolization
4.1 Preparation After examining and determining the source of hemoptysis originating from the bronchial artery and the patient is in a condition to be able to perform the procedure, the doctor will order bronchial embolization and instruct the patient to prepare in advance such as: Fasting, drinking within 6 hours before bronchial embolization, can drink no more than 50ml of water. Blood clotting and bleeding tests Kidney function tests Electrocardiogram .
4.2 Bronchial angiography At the procedure room: The patient is asked to lie on his or her back under the light screen, various types of breathing monitoring equipment, electrocardiogram, blood pressure, pulse, SpO2 are installed and monitored. track. For patients who are not conscious or young, bronchial embolism can be anesthetized if necessary. The inguinal area on both sides of the patient is disinfected, this is the way to the femoral artery leading to the bronchial artery. The entire patient is covered with chancre, only the puncture site is open. The doctor inserts a small tube (microcatheter) from the thigh that has just been disinfected into the aorta, then selectively inserts it into the bronchial artery according to the magnifying screen. Inject the contrast agent and conduct bronchial angiography to locate the damaged bronchi leading to hemoptysis. Continue to insert the smaller catheter into the lumen of the catheter to the location of the damaged vessel in the bronchi. The damaged or abnormally dilated arteries in the bronchi will be blocked with some specialized bronchial embolization materials such as: PVA beads, biological glue, metal spiral or spongel.. After taking and embolizing the bronchi, the doctor proceeds to withdraw all kinds of catheters from the vessel. The opening of the lumen was hemostasised by manual compression for 15 min and instrumental compression for 6 h thereafter. The time taken for angiography and digitized bronchial embolization to clear the background is approximately 60 to 90 minutes. When performing bronchial embolization, the patient will not experience discomfort or pain. Your doctor will monitor functional parameters such as blood pressure, heart rate, during the procedure and 4 hours after the procedure. After the procedure, the patient must keep the bronchial embolization leg straight as well as lie still in place. 2 hours later, the patient can eat and drink again, after 18 hours can walk and do normal activities. If no complications occurred after 3 days, the patient was allowed to leave the hospital.
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