Bronchial artery embolization for massive hemoptysis: Long-term follow-up
Autor: | Alexander Belenky, Victoria Rusanov, Sonia Schneer, Oren Fruchter, Mordechai R. Kramer |
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Rok vydání: | 2014 |
Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Hemoptysis medicine.medical_specialty Lung Neoplasms Time Factors Long term follow up medicine.medical_treatment Bronchial Arteries Kaplan-Meier Estimate Severity of Illness Index Recurrence Risk Factors medicine.artery Multidetector Computed Tomography medicine Humans Embolization Israel Aged Retrospective Studies Aged 80 and over Bronchiectasis medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease Embolization Therapeutic Surgery Treatment Outcome medicine.anatomical_structure Angiography Recurrent bleeding Etiology Female Radiology Cardiology and Cardiovascular Medicine Bronchial artery business Artery |
Zdroj: | Asian Cardiovascular and Thoracic Annals. 23:55-60 |
ISSN: | 1816-5370 0218-4923 |
Popis: | Aim Bronchial artery angiography with embolization has become a mainstay in the treatment of massive hemoptysis. Whereas the immediate success rate is high, the reported long-term success rate varies widely among different groups. We aimed to explore the long-term outcome and clinical predictors associated with recurrent bleeding following bronchial artery embolization. Methods We reviewed the clinical characteristics, underlying etiologies, procedure details, and outcome of bronchial artery embolization performed for massive hemoptysis between 1999 and 2012. Results All 52 consecutive patients treated by bronchial artery embolization during the study period were included. The major etiologies of massive hemoptysis were bronchiectasis (mostly post-infectious) in 53.8%, and primary and metastatic lung cancer in 30.8%. The immediate success rate was high (48/52; 92%). Of 45 patients who survived more than 24 hours following bronchial artery embolization, recurrent bleeding did not occur in 19 (42.2%) during a median follow-up period of 60 months (range 6–130 months). Bleeding recurred in 26 (57.7%); within 30 days in 15 (33.3%) and after 1 month in the other 11 (24.4%). The average time to onset of early and late repeat bleeding was 2 and 506 days, respectively. Idiopathic bronchiectasis and lung cancer were associated with a high likelihood of late bleeding recurrence. Conclusions Bronchial artery embolization is an effective immediate treatment for massive hemoptysis. Because the bleeding recurrence rate is high in patients with lung cancer or idiopathic bronchiectasis, surgery should be considered in these patients following initial stabilization by bronchial artery embolization. For other underlying etiologies, the long-term outcome is excellent. |
Databáze: | OpenAIRE |
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