A literature case study presented on the bronchoscopic management of hemoptysis caused by airway erosion from vascular coils. patient suffered from hughes-stovin syndrome, antiphospholipid antibody syndrome, and recurrent pulmonary emboli receiving chronic immune suppression and chronic anticoagulation and presented with massive hemoptysis.One year prior, the patient had developed massive hemoptysis due to a left lower lobe pulmonary artery aneurysmal rupture treated with surgical resection. three months prior, a patient developed massive hemoptysis secondary to the right lower lobe (rll) aneurysmal rupture, which was treated with vascular coil embolization.Cross-sectional imaging at the site showed the most likely source of bleeding to be an erosion of a vascular coil through a vessel wall into the rll anterior segment bronchus. bilateral airway inspection showed no fresh bleeding and no grossly apparent vascular abnormalities but a small amount of old blood in the rll bronchial tree and vascular coils visible in the r b8 segmental bronchus. it was decided to attempt to maximize local containment in the event of massive future re-bleeding from with area.The patient was referred for bronchoscopic management to maximize local containment in the event of massive future re-bleeding from the area (right lower lobe). multiple surgicel strips were placed in r b8 to bolster local hemostasis.A combination of spiration endobronchial valve (ebv) and tisseel fibrin glue on either side of the valve was placed more proximally.Around 1-month after surgical referral, it was reported the patient suffered another massive hemoptysis (possibly due to disintegration of the valve-glue complex over time or due to a fresh aneurysmal rupture) that resulted in cardiac arrest and ultimately patient death.
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