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Bronchial artery embolization for hemoptysis: a retrospective observational study of 344 patients.

Shao H, Wu J, Wu Q, Sun X, Li L, Xing Z, Sun H - Chin. Med. J. (2015)

Bottom Line: Several aspects of outcome were analyzed: Demographics, clinical presentation, radiographic studies, results, complications and follow-up of BAE.The complications of BAE are rare.Although the long-term outcome in some patients is not good, BAE may be the only life-saving treatment option in patients who are poor surgical candidates.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary Medicine, Tianjin Haihe Hospital; Tianjin Institute of Respiratory Disease, Tianjin 300350, China.

ABSTRACT

Background: Hemoptysis is a significant clinical entity with high morbidity and potential mortality. Both medical management (in terms of resuscitation and bronchoscopic interventions) and surgery have severe limitations in these patients population. Bronchial artery embolization (BAE) represents the first-line treatment for hemoptysis. This article discusses clinical analysis, embolization approach, outcomes and complications of BAE for the treatment of hemoptysis.

Methods: A retrospective analysis of 344 cases, who underwent bronchial arteriography at Tianjin Haihe Hospital between 2006 and 2013. Several aspects of outcome were analyzed: Demographics, clinical presentation, radiographic studies, results, complications and follow-up of BAE.

Results: Three hundred and forty-four consecutive patients underwent bronchial arteriography, 336 of 344 patients (97.7%) performed BAE; there were 1530 coils for 920 arteries embolized; the main responsible sources for bleeding were right bronchial artery (29.7%), left bronchial artery (21.6%), combined right and left bronchial trunk (18.4%), right intercostal arteries (13.3%); 61 patients (17.7%) had recurrent hemoptysis within 1 month after undergoing BAE, 74 patients (21.5%) had recurrent hemoptysis over 1 month after undergoing BAE; The common complications of BAE included subintimal dissection, arterial perforation by a guide wire, fever, chest pain, dyspnea, etc. The follow-up was completed in 248 patients, 28 patients had been dead, 21 patients still bleed, 92 patients had lost to follow-up.

Conclusions: The technique of BAE is a relatively safe and effective method for controlling hemoptysis . The complications of BAE are rare. Although the long-term outcome in some patients is not good, BAE may be the only life-saving treatment option in patients who are poor surgical candidates.

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The ratio of responsible bronchial arteries.
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Figure 1: The ratio of responsible bronchial arteries.

Mentions: Bronchial arteriography was performed in all patients. All available bronchial arteriograms (which were performed in 344 patients) were reviewed. The findings of angiography suggested that few direct sign found during arteriography, most of the indirect appearances that support a site of bleeding include tortuosity, hypertrophy, hypervascularity, aneurysms, extravasation, and bronchial artery to pulmonary artery or vein shunting. In 131 patients (38.1%), only left-side bronchial arteries were abnormal; in 69 patients, only right-side bronchial arteries were abnormal; in the other 144 patients, bilateral bronchial arteries were abnormal. As the statistics, 944 responsible bronchial arteries involves in according to the angiography: 275 right bronchial arteries; 200 left bronchial arteries; 170 combined right and left bronchial trunk; 123 right intercostal arteries; other 176 arteries [Figure 1]. We analyzed the responsible arteries for tuberculosis, bronchiectasis, bronchogenic carcinomas and undefined reasons as follow [Table 1]. A spinal artery was identified in three patients, one spinal artery originated from the left bronchial artery, one from the right intercostal artery, and one from the right subclavian artery.


Bronchial artery embolization for hemoptysis: a retrospective observational study of 344 patients.

Shao H, Wu J, Wu Q, Sun X, Li L, Xing Z, Sun H - Chin. Med. J. (2015)

The ratio of responsible bronchial arteries.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837820&req=5

Figure 1: The ratio of responsible bronchial arteries.
Mentions: Bronchial arteriography was performed in all patients. All available bronchial arteriograms (which were performed in 344 patients) were reviewed. The findings of angiography suggested that few direct sign found during arteriography, most of the indirect appearances that support a site of bleeding include tortuosity, hypertrophy, hypervascularity, aneurysms, extravasation, and bronchial artery to pulmonary artery or vein shunting. In 131 patients (38.1%), only left-side bronchial arteries were abnormal; in 69 patients, only right-side bronchial arteries were abnormal; in the other 144 patients, bilateral bronchial arteries were abnormal. As the statistics, 944 responsible bronchial arteries involves in according to the angiography: 275 right bronchial arteries; 200 left bronchial arteries; 170 combined right and left bronchial trunk; 123 right intercostal arteries; other 176 arteries [Figure 1]. We analyzed the responsible arteries for tuberculosis, bronchiectasis, bronchogenic carcinomas and undefined reasons as follow [Table 1]. A spinal artery was identified in three patients, one spinal artery originated from the left bronchial artery, one from the right intercostal artery, and one from the right subclavian artery.

Bottom Line: Several aspects of outcome were analyzed: Demographics, clinical presentation, radiographic studies, results, complications and follow-up of BAE.The complications of BAE are rare.Although the long-term outcome in some patients is not good, BAE may be the only life-saving treatment option in patients who are poor surgical candidates.

View Article: PubMed Central - PubMed

Affiliation: Division of Pulmonary Medicine, Tianjin Haihe Hospital; Tianjin Institute of Respiratory Disease, Tianjin 300350, China.

ABSTRACT

Background: Hemoptysis is a significant clinical entity with high morbidity and potential mortality. Both medical management (in terms of resuscitation and bronchoscopic interventions) and surgery have severe limitations in these patients population. Bronchial artery embolization (BAE) represents the first-line treatment for hemoptysis. This article discusses clinical analysis, embolization approach, outcomes and complications of BAE for the treatment of hemoptysis.

Methods: A retrospective analysis of 344 cases, who underwent bronchial arteriography at Tianjin Haihe Hospital between 2006 and 2013. Several aspects of outcome were analyzed: Demographics, clinical presentation, radiographic studies, results, complications and follow-up of BAE.

Results: Three hundred and forty-four consecutive patients underwent bronchial arteriography, 336 of 344 patients (97.7%) performed BAE; there were 1530 coils for 920 arteries embolized; the main responsible sources for bleeding were right bronchial artery (29.7%), left bronchial artery (21.6%), combined right and left bronchial trunk (18.4%), right intercostal arteries (13.3%); 61 patients (17.7%) had recurrent hemoptysis within 1 month after undergoing BAE, 74 patients (21.5%) had recurrent hemoptysis over 1 month after undergoing BAE; The common complications of BAE included subintimal dissection, arterial perforation by a guide wire, fever, chest pain, dyspnea, etc. The follow-up was completed in 248 patients, 28 patients had been dead, 21 patients still bleed, 92 patients had lost to follow-up.

Conclusions: The technique of BAE is a relatively safe and effective method for controlling hemoptysis . The complications of BAE are rare. Although the long-term outcome in some patients is not good, BAE may be the only life-saving treatment option in patients who are poor surgical candidates.

Show MeSH
Related in: MedlinePlus