Preemptive non-selective bronchial artery angioembolization to reduce recurrence rate of hemoptysis.

IF 2.3
Multidisciplinary Respiratory Medicine Pub Date : 2020-12-30 eCollection Date: 2020-01-28 DOI:10.4081/mrm.2020.723
Mohammad Sadegh Keshmiri, Shadi Shafaghi, Babak Sharif-Kashani, Ali Sadoughi, Fariba Ghorbani, Farah Naghashzadeh, Atefeh Abedini
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引用次数: 3

Abstract

Background: Massive hemoptysis which is presented in advanced lung diseases is a life-threatening condition. Bronchial artery embolization as a minimally invasive procedure is the treatment of choice either in first or recurrent hemoptysis. This study aimed to assess the early and late efficacy of bronchial angioembolization (BAE) without microcatheter.

Methods: In this prospective cohort study, all patients with hemoptysis who had undergone BAE from August 2018 to March 2019 were included. Angiographic patterns including bleeding sources, number of involved vessels, the underlying etiology, and recurrence rate were evaluated in a one-year follow up.

Results: 153 patients were included with mean age of 55 ±16 years. 68% of them were male and 58% had life-threatening massive hemoptysis. Three distinct angiographic patterns were recognized. The culprit bleeding vessel was bronchial in 126 (92%), intercostal in 4 (3%), and both vessels in 7 (5%) of cases (p<0.05). One vessel involvement was seen in 56 patients; however it was observed in 69% of non-cystic fibrosis lobar bronchiectasis patients. In 1, 3 and 12 months follow up, recurrent hemoptysis was reported in 15 (11%), 4 (2.5%), and 24 (15.5%), respectively. In 52% of cases, no abnormal vessels were observed during aorta injection, but culprit bronchial or intercostal arteries were found in selective investigational angiography.

Conclusion: BAE was successful in the control of hemoptysis and resulted in a low rate of recurrence in different types of lung diseases. This could be due to the embolization of all pathological arteries found during angiography which might have prevented recurrent bleeding.

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预防性非选择性支气管动脉血管栓塞术降低咯血复发率。
背景:在晚期肺部疾病中出现的大咯血是一种危及生命的疾病。支气管动脉栓塞作为一种微创手术是治疗首次或复发性咯血的首选方法。本研究旨在评价无微导管支气管血管栓塞术(BAE)的早期和晚期疗效。方法:在这项前瞻性队列研究中,纳入了2018年8月至2019年3月期间接受BAE治疗的所有咯血患者。血管造影模式包括出血来源、受累血管数量、潜在病因和复发率在一年的随访中进行评估。结果:153例患者入组,平均年龄55±16岁。其中68%为男性,58%有危及生命的大咯血。三种不同的血管造影模式被确认。126例(92%)为支气管出血血管,4例(3%)为肋间出血血管,7例(5%)为双血管出血血管。结论:在不同类型的肺部疾病中,BAE成功地控制了咯血,复发率低。这可能是由于在血管造影中发现的所有病理动脉的栓塞可能阻止了复发性出血。
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来源期刊
Multidisciplinary Respiratory Medicine
Multidisciplinary Respiratory Medicine Medicine-Pulmonary and Respiratory Medicine
自引率
0.00%
发文量
23
期刊介绍: Multidisciplinary Respiratory Medicine is the official journal of the Italian Respiratory Society - Società Italiana di Pneumologia (IRS/SIP). The journal publishes on all aspects of respiratory medicine and related fields, with a particular focus on interdisciplinary and translational research. The interdisciplinary nature of the journal provides a unique opportunity for researchers, clinicians and healthcare professionals across specialties to collaborate and exchange information. The journal provides a high visibility platform for the publication and dissemination of top quality original scientific articles, reviews and important position papers documenting clinical and experimental advances.
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