Treatment of massive haemoptysis with microcoil embolization after en bloc double-lung transplantation with bronchial artery revascularization.

Successful treatment of a severe haemoptysis with microcoil embolization in an en block double-lung transplanted patient is described. A 53 year old woman with advanced bronchiolitis obliterans syndrome experienced severe haemoptysis 26 months after an en bloc double-lung transplantation with direct bronchial artery revascularization using the left internal mammary artery. Bronchoscopy showed that the haemoptysis originated from the lingula. Only two months after the transplant, left internal mammary arteriograms revealed proliferation and enlargement of the bronchial arteries in the lingula. The early occurrence of the vascular malformation indicated a pre-existing bronchiectasis in the donor lung, possibly due to tobacco smoking. After uncomplicated microcoil embolization of the left internal mammary artery, the patient experienced no further episodes of haemoptysis. Microcoil embolization can be used successfully to treat massive haemoptysis related to proliferated and enlarged bronchial arteries in transplanted lungs with bronchial artery revascularization.