Preliminary investigation of the significance of cavitary lesions in recurrent hemoptysis following bronchial artery embolization for nontuberculous mycobacterial pulmonary disease

IF 2.4 Q2 RESPIRATORY SYSTEM

Respiratory investigation Pub Date : 2024-11-01 DOI:10.1016/j.resinv.2024.11.001

Hiroto Hatano, Manabu Suzuki, Mio Sugino, Mikako Nakamura, Yusaku Kusaba, Yoshie Tsujimoto, Akane Ishida, Masao Hashimoto, Eriko Morino, Jin Takasaki, Naoki Nishimura, Hiroshi Nokihara, Shinyu Izumi, Masayuki Hojo

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引用次数: 0

Abstract

Background

Nontuberculous mycobacterial pulmonary disease (NTM-PD) varies widely in clinical presentation, and some patients experience hemoptysis. Bronchial artery embolization (BAE) is a treatment option for hemoptysis caused by NTM-PD. However, the association between post-BAE rebleeding risk and the presence of cavitary lesions has not been fully elucidated.

Methods

A retrospective observational study was conducted on patients with NTM-PD who had undergone BAE at our institution. Patients were classified into Cavitary and Non-cavitary groups, and baseline characteristics and clinical outcomes were compared.

Results

Among the 155 BAE cases between 2013 and 2023, 18 were included in the analysis, and four experienced rebleeding. The Cavitary group tended to have a higher rebleeding rate 24 months after BAE (37.5% vs. 10.0%, p = 0.27). Furthermore, the Cavitary group showed a significantly higher number of non-bronchial arteries involved (median number: 1.5 vs. 0.0, p = 0.02), a higher proportion of patients with a prior antibiotic treatment history (100% vs. 20%, p = 0.001), and longer duration from diagnosis to BAE (median year: 9.0 vs. 0.6, p = 0.02). The Kaplan-Meier curves showed a tendency for shorter rebleeding-free survival in the Cavitary group (p = 0.10).

Conclusions

Cavitary lesions in patients with NTM-PD may predict higher rebleeding rates after BAE. Further research with larger cohorts is needed to better understand rebleeding risk factors in BAE for NTM-PD.

查看原文本刊更多论文

支气管动脉栓塞治疗非结核分枝杆菌肺病后复发性咯血中空洞病变重要性的初步研究。

背景：非结核分枝杆菌肺病（NTM-PD）的临床表现千差万别，部分患者会出现咯血。支气管动脉栓塞术（BAE）是治疗非结核分枝杆菌肺病引起的咯血的一种方法。然而，BAE术后再出血风险与是否存在空洞性病变之间的关系尚未完全阐明：我们对在本院接受 BAE 的 NTM-PD 患者进行了一项回顾性观察研究。将患者分为腔隙性和非腔隙性两组，并比较基线特征和临床结果：在2013年至2023年的155例BAE病例中，有18例纳入分析，其中4例出现再出血。腔镜组在 BAE 24 个月后的再出血率往往更高（37.5% 对 10.0%，P = 0.27）。此外，腔镜组非支气管动脉受累的数量明显更高（中位数：1.5 对 0.0，p = 0.02），既往有抗生素治疗史的患者比例更高（100% 对 20%，p = 0.001），从诊断到 BAE 的时间更长（中位数：9.0 年对 0.6 年，p = 0.02）。Kaplan-Meier曲线显示，腔隙性病变组的无再出血生存期更短（p = 0.10）：结论：NTM-PD 患者的腔隙性病变可能预示着 BAE 后较高的再出血率。要更好地了解 NTM-PD BAE 的再出血风险因素，还需要对更大的队列进行进一步研究。

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

Respiratory investigation RESPIRATORY SYSTEM-

CiteScore

4.90

自引率

6.50%

发文量

114

审稿时长

64 days