Efficacy of Amplatzer device for endobronchial treatment of hemoptysis: case series

Background: Hemoptysis is a potentially life-threatening condition attributable to various pulmonary diseases. Bronchoscopy plays an important role in hemoptysis management to localize and treat the source of bleeding. While deployment of endobronchial blockers to achieve hemostasis has been widely described, the repurpose of the Amplatzer^TM Vascular Plug device (AVPD), designed for vascular embolization, for endobronchial bleeding has been rarely described. The aim of this study is to present our experience with AVPD for managing hemoptysis and assess its efficacy as a treatment option. Methods: We conducted a retrospective analysis of patients admitted to our tertiary medical center with massive or sub-massive hemoptysis where an AVPD was deployed during bronchoscopy to achieve hemostasis. We collected demographic data, medical history, hemoptysis etiology, bronchoscopy procedures, hemostasis outcomes and follow-up. Results: Fifteen patients with a median age of 60 years (range, 24–86 years) with massive or sub-massive hemoptysis were treated with endobronchial deployment of an AVPD. Eleven patients (73%) suffered from massive hemoptysis. AVPD deployment successfully achieved concurrent hemostasis in 14 (93%) cases, with four patients requiring subsequent surgical or endovascular treatments to achieve definitive hemostasis. In 5 (33%) cases, the AVPD was subsequently removed after a median period of 23 days, with no recurrent hemoptysis. Three patients (20%) expired within a week of the bronchoscopy for causes unrelated to the AVPD deployment or hemoptysis. Conclusions: Endobronchial deployment of AVPD is an effective management tool for hemoptysis either as a definitive treatment or as a bridge to surgical or endovascular treatment. To our knowledge, this is the first case series of AVPD use for hemoptysis management. Further research encompassing a larger patient population including comparison of results with standard of care treatment is required to further substantiate our results.