BackTable Vascular & Interventional Ep. 586 Bronchial Artery Embolization: Techniques, Outcomes & Complications to Avoid with Dr. Alex Lam
Nov 4, 2025
Dr. Alex Lam, an assistant professor at UCSF specializing in interventional radiology, dives into bronchial artery embolization techniques and outcomes. He highlights the key factors for successful procedures, including patient evaluation and understanding causes of bronchial artery hypertrophy like tuberculosis and malignancy. Dr. Lam shares tips on catheter selection, the advantages of using glue over traditional particles, and how to manage complications effectively. With a success rate of over 90%, he emphasizes the importance of teamwork and detailed pre-procedure preparations.
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Get A CTA To Find Targets
- Always get a CTA when the patient is stabilized to identify enlarged bronchial arteries or targets for embolization.
- Use CTA to find tortuous or >2–3 mm bronchial arteries and airspace consolidation as procedural targets.
Non-Bronchial Feeders Are Common
- Up to ~20–30% of pulmonary systemic feeders can arise from non-bronchial sources like intercostals or internal mammaries.
- Searching beyond classic bronchial origins prevents missed bleeding sources.
Explicitly Discuss Risks During Consent
- Discuss risks thoroughly, especially neurologic risks like stroke, during consent before the procedure.
- Explain that definitions of massive hemoptysis vary and clinical deterioration—not volume—drives the decision to embolize.