Embolisation

Patients who cough up blood have many extra, small blood vessels, around the side of a cavity caused by CPA. These are connected to the bronchial and sytemic circulation, rather than to the pulmonary circulation, and are therefore at higher pressure.

If bleeding is frequent or substantial, a process called embolisation can be used to destroy these extra blood vessels.

To do this, a very long, sterile and flexible catheter is fed up through the body, starting from the groin to the chest, using radiological control to follow its insertion. The vessels that cause the bleeding are identified and a special gel is injected into the area feeding these vessels, because they are small, it gets trapped and blocks the vessels. A contrast dye is injected again to confirm that the all the affected blood vessels have been obliterated. Often cavities are fed by more than one major vessel, and 2 or 3 areas have to be injected. The procedure usually takes about 90 to 120 minutes, and it is performed whilst lying flat.