Bronchial Artery Embolisation for Massive Haemoptysis: Immediate and Long-Term Outcomes—A Retrospective Study (original) (raw)
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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.
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 ...
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.
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.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 2001
To determine the efficacy and cost-effectiveness of bronchial artery embolisation (BAE) in the treatment of major and massive haemoptysis in HIV-positive and negative patients with pulmonary inflammatory disease. A retrospective review of patients admitted over a period of 24 months to Wentworth Hospital with major haemoptysis treated using BAE. Eighty-seven patients were treated (77 males, 10 females). Bilateral disease was present in 50 patients (57%). Thirty-two patients were HIV-positive (37%). Embolisation was successfully performed in 77 patients (88.5%), and failed for technical reasons in 10 patients (11.5%). There was only one procedural complication. Fifty-seven patients had a successful outcome, with cessation of haemoptysis within 24 hours (66.5%). Haemoptysis continued in 30 patients (34%) (20 patients embolised and the 10 patients who had failed procedures). Fourteen of these patients (16%) required lobectomy or pneumonectomy as an emergency procedure. Five patients (5...
Bronchial Artery Embolization as a Therapeutic Strategy for Management of Massive Hemoptysis
2021
Background: Massive hemoptysis is an emergent and lifethreatening condition with a high mortality rate. Bronchoscopy and MDCT scanning show significant contributing roles in delineating the etiology and the source of hemoptysis prior to bronchial artery arteriography. Aim of the work: To validate the role of the trans-catheter bronchial artery embolization in management of massive hemoptysis. Patients and Methods: Our study is a prospective cohort study that was held during the period between April 2017 and April 2019. The study included 20 patients who presented with massive hemoptysis refractory to supportive treatment measures with nonidentifiable source of bleeding on fiber-optic bronchoscope. Patients were referred from chest department to angio unit. Results: Our findings are in accordance with the current literature supporting bronchial artery embolization as a safe and long-term non-invasive effective method of treatment for massive hemoptysis with a high initial rate of success. BAE may help to avoid surgery in patients who are not good surgical candidates. If hemoptysis recur in these patients, embolization can be safely performed with good response rate. If surgery is indicated, BAE can stabilize the patient prior to surgery. Conclusion: Advancements in angiographic equipment and technique continue to improve success rates, and with careful technique, it can be performed safely and with minimal risk. Embolization distal to the spinal artery may significantly decrease the number of complications and may allow a more thorough embolization.
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.
2017
Correspondence to Dr Masahiko Hara; masahiko.hara@dmi.med. osaka-u.ac.jp ABSTRACT Objectives: Evidence on the safety and long-term efficacy of super selective bronchial artery embolisation (ssBAE) using platinum coils in patients with haemoptysis is insufficient. The objective of the present study was to evaluate the safety and the 3-year postprocedure haemoptysis-free survival rate of de novo elective ssBAE using platinum coils rather than particles for the treatment of haemoptysis. Design: A single-centre retrospective observational study. Setting: Hemoptysis and Pulmonary Circulation Center in Japan. Participants: A total of 489 consecutive patients with massive and non-massive haemoptysis who underwent de novo elective ssBAE without malignancy or haemodialysis. Interventions: ssBAE using platinum coils. All patients underwent CT angiography before the procedure for identifying haemoptysis-related arteries (HRAs) and for procedural planning. Primary and secondary outcome measures...
ISRN Vascular Medicine (Print), 2013
Background. We aimed to report our experience with bronchial artery embolization (BAE) in the management of moderate recurrent and/or life-threatening hemoptysis. Methods. We evaluated the demographics, clinical presentation, radiographic studies, short-and long-term efficacy, and complications in patients Who underwent BAE, at a tertiary university hospital, from 2003 to 2012. Results. Three hundred forty-one patients underwent BAE for the management of moderate recurrent or life-threatening hemoptysis. Pulmonary TB and bronchiectasis were the most common etiologies for hemoptysis in our locality. The most common angiographic signs for hemoptysis were hypervascularity and systemic-pulmonary artery shunt. BAE was successful in controlling hemoptysis immediately in 95% of patients and at 1 month in 90% of patients. Recurrence of hemoptysis was observed in 9.6% of patients, and reembolization was indicated in 85% of those cases. Complications of BAE were self-limited acute and subacute complications, while chronic complications were not recorded during this study. Conclusions. TB and bronchiectasis are the commonest etiologies for moderate recurrent or life-threatening hemoptysis in our locality. Hypervascular lesions from the bronchial arteries and nonbronchial systemic arteries represented the major vascular abnormalities. Bronchial and nonbronchial systemic artery embolizations were effective to control both acute and chronic hemoptyses, with no serious complications.