Hemoptysis is the spitting of blood that originated in the lungs or bronchial tree. The patient’s history should help determine the amount of blood and differentiate between hemoptysis, pseudohemoptysis, and hematemesis. A focused physical examination can lead to the diagnosis in most cases. In children, lower respiratory tract infection and foreign body aspiration are the most common causes of hemoptysis, whereas in adults, bronchitis, bronchogenic carcinoma, and pneumonia are the major causes. Chest radiographs often aid in the diagnosis and assist in using two complementary diagnostic procedures, fiberoptic bronchoscopy and high-resolution computed tomography, which are useful in difficult cases and when malignancy is suspected. The most common presentation is acute, mild hemoptysis caused by bronchitis. Low-risk patients with normal chest radiographs can be treated on an outpatient basis with close monitoring and appropriate oral antibiotics, if clinically indicated (1). If hemoptysis persists, consultation with a pulmonologist should be considered. In up to 34 percent of patients, no cause of hemoptysis can be found (1). The more dangerous presentation is the massive hemoptysis. It is a life-threatening clinical condition requiring urgent assessment and intervention. The mortality rate from massive hemoptysis depends on the bleeding rate and etiology. Hemoptysis greater than 1,000 mL per 24 hours in the presence of malignancy carries a mortality rate of 80 percent (2). Patients with massive hemoptysis need to undergo more aggressive, expedient approach. Diagnosis and therapy must occur simultaneously. Airway maintenance is vital because the primary mechanism of death is asphyxiation, not exsanguination (1). One of the treatment options that enables relatively quick access to the site of bleeding while being minimally invasive is the endovascular embolization performed by interventional radiologists. Since it’s introduction in 1973 it became a well established, safe and effective treatment, in many clinical cases it has become the method of choice for massive hemoptysis (3). However, the problem with endovascular approach is that the long term results are hampered by recurrent bleedings. The purpose of this study is to present results of an analysis of hemoptysis recurrence after successful embolization and, if possible, identify the predisposing conditions.

Hemoptysis was considered to be massive if the blood loss was 300-600 ml per day in agreement with the most commonly used classification (4, 5, 6).

The underlying pathology in almost 80% was: tuberculosis (155 cases), bronchiectasis (98), aspergillosis (31). Remaining causes included cystic fibrosis (25), bronchogenic cancer (19), mucoviscidosis (6), vascular anomalies (2), and Rasmussen aneurysms (2).