Bronchial artery embolization using small particles is safe and effective: a single center 12-year experience.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Radiology Pub Date : 2024-12-01 Epub Date: 2024-06-11 DOI:10.1007/s00330-024-10836-y

Frances Sheehan, Alison Graham, N Paul Tait, Philip Ind, Ali Alsafi, James E Jackson

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引用次数: 0

Abstract

Background: Bronchial artery embolization (BAE) using particles is an established treatment for hemoptysis. The use of polyvinyl alcohol (PVA) with a particle size of 300 µm or larger is thought to reduce the risk of non-target embolization but may result in more proximal vessel occlusion than is ideal, resulting in a high rate of early recurrent hemorrhage.

Objective: This study evaluates the safety and efficacy of BAE using PVA particles with a size of less than 300 µm.

Methods: All patients who underwent BAE between 2010 and 2022 at a tertiary center were included. Demographic data, etiology and volume of hemoptysis, technical and clinical success, procedure-related complications, and follow-up information were collected from patients' electronic records. 150-250 µm PVA particles were used to commence embolization in all patients with the subsequent use of larger-sized particles in some individuals. The Kaplan-Meier method was used to estimate recurrence and survival rates.

Results: One hundred forty-four patients underwent 189 embolization procedures between 2010 and 2022 and were followed up for a median of 35 months [IQR 19-89]. 150 µm to 250 µm PVA particles were used as the sole embolic agent in 137 cases. Hemoptysis recurred within 30 days in 7%. The median time to repeat intervention was 144 days [IQR 42-441]. Seventeen out of 144 patients had a pulmonary artery branch pseudoaneurysm. The rate of major complications was 1% with no instances of stroke or spinal artery ischemia. Thirty-day mortality was 2% (4/189).

Conclusion: BAE using 150-250 µm PVA particles is safe and effective with few complications and low rates of early hemoptysis recurrence.

Clinical relevance statement: BAE using small particles is likely to improve outcomes, particularly the rate of early recurrence, in patients with hemoptysis, without an increase in procedural complications.

Key points: BAE is a safe and effective treatment for patients with hemoptysis. Using small PVA particles in BAE has few complications and low rates of early recurrence. Pulmonary artery pseudoaneurysms should be actively sought in those with hemoptysis undergoing BAE.

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使用小颗粒栓塞支气管动脉既安全又有效：单中心 12 年的经验。

背景：使用微粒进行支气管动脉栓塞 (BAE) 是一种治疗咯血的成熟方法。使用粒径为 300 微米或更大的聚乙烯醇 (PVA) 被认为可以降低非目标栓塞的风险，但可能会导致近端血管闭塞，从而导致早期复发性出血的高发生率：本研究评估了使用尺寸小于 300 µm 的 PVA 粒子进行 BAE 的安全性和有效性：方法：纳入 2010 年至 2022 年期间在一家三级中心接受 BAE 的所有患者。从患者的电子病历中收集人口统计学数据、咯血的病因和量、技术和临床成功率、手术相关并发症以及随访信息。所有患者均使用 150-250 微米的 PVA 粒子开始栓塞，部分患者随后使用了更大尺寸的粒子。采用 Kaplan-Meier 法估算复发率和存活率：144名患者在2010年至2022年期间接受了189次栓塞手术，随访时间中位数为35个月[IQR 19-89]。在 137 个病例中，150 微米至 250 微米的 PVA 粒子被用作唯一的栓塞剂。7%的患者在 30 天内再次咯血。重复干预的中位时间为 144 天 [IQR 42-441]。144 例患者中有 17 例出现肺动脉分支假性动脉瘤。主要并发症发生率为1%，无中风或脊髓动脉缺血病例。30天死亡率为2%（4/189）：结论：使用 150-250 µm PVA 颗粒进行 BAE 安全有效，并发症少，早期咯血复发率低：临床相关性声明：使用小颗粒的 BAE 有可能改善咯血患者的治疗效果，尤其是早期复发率，同时不会增加手术并发症：要点：BAE 是治疗咯血患者的一种安全有效的方法。要点：在 BAE 中使用小的 PVA 颗粒，并发症少，早期复发率低。接受 BAE 治疗的咯血患者应积极寻找肺动脉假性动脉瘤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.