Efficacy and cost-effectiveness of bronchial arterial embolisation in the treatment of major haemoptysis (original) (raw)
Related papers
Transcatheter embolization of bronchial arteries in the treatment of haemoptysis
Radiology and Oncology, 2009
Materials and methods. Series of 11 patients with the clinical picture of massive haemoptysis was referred to our hospital for digital subtraction angiography and BAE within a 33 months period. There were 8 male (aged 43-69, mean age 56) and 3 female patients (aged 63-65, mean age 64). Aortography of thoracic aorta was initially performed in all patients, followed by selective angiography of bronchial and intercostal arteries, and intercostobronchial tree as indicated. A selective arterial embolization was done in 9 patients (9 primary and 3 secondary embolizations). The embolization was performed under fluoroscopy control by manual injection of the mixture of contrast solution (1 ccm) and embolization material, Embosphere (BioSphere Medical Inc., MA, USA), particle size 350-500 µm. Results. Bronchiectasis was the most common cause of bleeding (45.4%), while hypervascularization and intensive parenchymal opacification were the most frequent angiographic indicators of bleeding (100%), followed by tortuous and hypertrophic arteries (72.7%). Primary BAE proved successful in 81.9% and secondary BAE performed within 24 months in 33.3% of patients, whereas the tertiary (operative) treatment was required in 22.2% of patients. In 44.4% of patients, BAE was associated with only mild discomforts, like pain and cough. Conclusions. BAE is a reliable and minimally invasive method in the management of massive haemoptysis. Therefore, it should be considered as the primary method of the treatment or as a procedure for the stabilization the patient before the surgery.
Outcomes and safety of bronchial artery embolization in control of massive hemoptysis
Egyptian Journal of Bronchology, 2019
Background The most frequent causes of massive hemoptysis are bronchiectasis, myecetoma, tuberculosis, bronchial carcinoma, and cryptogenic hemoptysis. Objective This study aimed to investigate the outcomes, safety, and complications of bronchial artery embolization (BAE) in the management of massive hemoptysis. Patients and methods This study included 32 patients who presented with massive hemoptysis who were indicated for BAE. The following data were obtained from each patient: detailed history, clinical examination, chest radiograph, computed tomography pulmonary angiography, fiberoptic bronchoscopy, and BAE. Results Fifteen patients underwent BAE as an urgent procedure for control of massive hemoptysis and 17 patients underwent BAE as an elective procedure. The complications of BAE were fever in four patients (12.5%), back pain in three (9.38%), failure of BAE in two (6.25%), recurrence of hemoptysis in one (3.13%), and no mortality. BAE was successful in 30 out of 32 (93.75%) cases. Failure of catheterization was encountered in one (3.13%) case because of dissection during negotiations; therefore, no catheterization was performed. The second (3.13%) case showed extensive bronchial-pulmonary shunt with severe lung destruction, so that the procedure was deemed futile. After the procedure, immediate control of hemoptysis was achieved in 29 (90.62%) patients. Conclusion BAE can be used safely and effectively for control of massive hemoptysis; it can be used as an alternative nonsurgical option along with medical treatment or as a bridge to stabilize the patient until definitive surgical management can be performed. BAE can be considered an alternative to surgery if the patient is not fit for surgical intervention.
Erciyes Medical Journal , 2021
We aimed to evaluate retrospectively the data of patients undergoing bronchial artery embolizatıon (BAE) for massive or non-massive hemoptysis in our clinic and discussed with the literature. Materials and Methods: We retrospectively evaluated patients with acute severe or chronic recurrent hemoptysis admitted to the pulmonology department and submitted to BAE for the purpose of embolization. Results: A total of 52 patients were submitted to BAE, 41 (78.8%) were male, with a mean age 53.7±14.8 years. Hemoptysis was considered severe in 22 (42.3%) patients. Bronchiectasis (other than cystic fibrosis) (n=12; 23.1%) and tuberculosis (TB) sequelae (n=11; 21.2) were the major etiology for hemoptysis. None of our patients developed early or late complications related to the procedure. Hemoptysis recurred in five patients at 12-month follow-up of each patient. There was no significant difference between the amount of hemoptysis and the presence of lesion on computed tomography, active bleeding on bronchoscopy or recurrence. Conclusion: Bronchiectasis (except those associated with cystic fibrosis), TB, and TB sequelae were the major etiologies for hemoptysis. Our results show that BAE is a safe and effective treatment supporting the current literature for acute massive and chronic recurrent hemoptysis.
Revista Portuguesa de Pneumologia (English Edition), 2016
Background: Bronchial artery embolisation (BAE) becomes a mainstay in the treatment of hemoptysis. Objective: To characterise patients with hemoptysis undergoing bronchial artery angiography (BAA) for embolisation, evaluating outcomes. Methods: We retrospectively evaluated patients with acute severe or chronic recurrent hemoptysis admitted to the Pulmonology department and submitted to BAA for purpose of embolisation. Results: A total of 88 patients were submitted to BAA, 47 (53.4%) were male, with a mean age of 61.4 ± 15.8 years. In 64 (72.7%) patients, hemoptysis presented as chronic recurrent episodes. Hemoptysis was considered severe in 40 (45.5%) patients. Bronchiectasis (other than cystic fibrosis) (n = 35; 38.0%) and tuberculosis sequelae (n = 31; 35.2) were the major aetiology for hemoptysis. The main angiographic abnormality was hypertrophy and tortuosity (n = 68; 77.3%). BAE was performed in 67 (76.1%) of the 88 patients submitted to BAA. Immediate success was achieved in 66 (98.5%) patients. Recurrence of hemoptysis occurred in 25 (37.3%) patients, and was related to presence of shunting (p = 0.049). The procedure-related complications were self-limited. Conclusion: Our results suggest that BAE is a safe and effective treatment for acute severe and chronic recurrent hemoptysis, supporting the current literature. Besides this, bleeding recurrence was relatively high, and correlated with presence of systemic pulmonary shunting.
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2008
To examine the efficacy and safety of bronchial artery embolisation in patients with acute major haemoptysis and those with chronic recurrent haemoptysis. Retrospective review of clinical records. Regional hospital, Hong Kong. Clinical records of 70 consecutive patients who had undergone bronchial artery embolisation in Queen Elizabeth Hospital from 1998 to 2003 were reviewed. Altogether 74 bronchial artery embolisation procedures were attempted, 46 (62%) for acute major haemoptysis, and 28 (38%) for chronic recurrent bleeding. Follow-up data were available for 32 patients. After bronchial artery embolisation, the Kaplan-Meier method and log-rank tests were used to compare the probability of recurrence in the two patient categories. Overall immediate control was attained following 99% of the procedures, with a complication rate of 13%; all complications were mild and self-limiting. For the 32 patients (19 having acute major haemoptysis and 13 having chronic recurrent bleeding) with ...
Pulmonary Therapy, 2020
Introduction Bronchial artery embolisation (BAE) is an established treatment method for massive haemoptysis. The aim of this study is to evaluate the impact of BAE on in-hospital outcomes and long-term survival in patients with massive haemoptysis. Methods Retrospective review of all cases of acute massive haemoptysis treated by BAE between April 2000 and April 2012 with at least a 5 year follow up of each patient. Targeted BAE was performed in cases with lateralising symptoms, bronchoscopic sites of bleeding or angiographic unilateral abnormal vasculature. In the absence of lateralising symptoms or signs, bilateral BAE was performed. Results 96 BAEs were performed in 68 patients. The majority (64 cases, 67%) underwent unilateral procedures. 83 (86.5%) procedures resulted in immediate/short term control of haemoptysis which lasted for longer than a month. The mean duration of haemoptysis free period after embolisation was 96 months. There were three major complications (cardio-pulmo...
Radiologia Medica, 2012
See www.rsna .org/education /rg_cme.html. LEARNING OBJECTIVES After reading this article and taking the test, the reader will be able to: Ⅲ List the most common causes of massive hemoptysis. Ⅲ Discuss the roles of CT and bronchoscopy in the diagnosis of massive hemoptysis. Ⅲ Describe the techniques, embolic materials, results, and complications associated with BAE for massive hemoptysis.
Eurasian Journal of Pulmonology, 2022
BACKGROUND AND AIM: The aim of this study is to evaluate the etiology, length of stay, treatment modality and treatment success in patients who underwent bronchoscopy due to massive hemoptysis. METHODS: The study is a cross-sectional study and was carried out with 148 patients who were transferred to our center with the complaint of massive hemoptysis between January 1, 2018 and January 1, 2021. RESULTS: The average age of the study group is 55.64±17.54. 71.6% of the patients in the study group were male. Etiological causes of patients with massive hemoptysis who underwent bronchoscopy were determined as bronchiectasis, lung cancer, tuberculosis, arterio-venous malformation and aspergilloma, respectively. The patients underwent 64.9% bronchial artery embolization (BAE), 29.7% medical treatment and 5.4% surgical treatment. The average length of stay in the intensive care unit is 4.66 days, while the length of stay in the service is 3.51 days. Relapse was seen in 9.45% of patients after BAE. The mean time to recurrence was 137.28 days. It was determined that hemoptysis recurred under 90 days in 8 cases and over 90 days in 6 cases. The success rate of BAE treatment was 90.55% and no mortal complications were observed. CONCLUSIONS: Massive hemoptysis is a life-threatening and urgent condition. Maintaining airway patency and controlling bleeding is a priority. We think that the patient should be hospitalized and followed up in the intensive care unit, contrast-enhanced thorax computed tomography and bronchoscopy should be performed in the rapid diagnosis process, BAE should be preferred first in the treatment, and surgical and other treatments should be applied if necessary.
Bronchial Artery Embolisation in Massive Haemoptysis
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Bronchial artery embolisation is a minimally invasive procedure in life-threatening massive haemoptysis due to markedly hypertrophied and fragile bronchial arteries occurring in patients with chronic inflammatory lung diseases such as bronchiectasis, sarcoidosis, tuberculosis, or cystic fibrosis.
Bronchial artery embolization in the treatment of hemoptysis: Our Hospital’s Experience
2021
Background: Hemoptysis is one of the most alarming condition to both the patients suffering from it and the treating physicians. It is caused due to varied etiologies. One of the emergent and at times life-saving treatment option is by minimally invasive interventional radiological technique of Bronchial Atery Embolization (BAE). The authors aimed to carry out a retrospective analysis of short term efficacy and safety of all patients treated by this technique at a tertiary care thoracic centre. Methods: A total of 52 patients were included in the study who had a median follow up of 35 days. All these patients were referred for hemoptysis, intractable hemoptysis not controlled by conservative management or massive hemoptysis. An analysis of the underlying etiology, immediate and short term outcomes and complications was made. Results: The study showed Tuberculosis and its sequel (bronchiectasis and chronic fibrotic changes) as the commonest etiology (65%). The BAE showed high short term efficacy (92%) in stopping the hemoptysis with a relatively low complication rate especially of major complications such as spinal cord ischemia (1.9%). The study strengthens the limited Indian data available on the subject and based on its outcome, BAE should be tried in all patients presenting with uncontrollable or massive hemoptysis not getting relief by conservative management alone. Conclusion: BAE is a very effective procedure with very less complications for management of massive or uncontrollable hemoptysis.