Bronchial arterial embolization may reduce the risk of severe bleeding in central airway obstruction due to renal cell carcinomas during bronchoscopic procedures

Autor: Hong Gao, Nan Zhang, Hongwu Wang, Zhi‐Na Wang, Meimei Tao, Hongming Ma
Rok vydání: 2020
Předmět:
Adult
Male
Pulmonary and Respiratory Medicine
Severe bleeding
renal cell carcinoma
medicine.medical_specialty
Cell
Hemorrhage
Bronchial Arteries
03 medical and health sciences
0302 clinical medicine
Renal cell carcinoma
Bronchoscopy
interventional bronchoscopy
Humans
Medicine
Central airway
Pharmacology (medical)
In patient
Intraoperative Complications
Carcinoma
Renal Cell
Aged
Retrospective Studies
Original Research
lcsh:RC705-779
Aged
80 and over
business.industry
Arterial Embolization
Bronchial Neoplasms
bronchial artery embolism
lcsh:Diseases of the respiratory system
Middle Aged
medicine.disease
Embolization
Therapeutic
Kidney Neoplasms
Surgery
Airway Obstruction
medicine.anatomical_structure
030228 respiratory system
central airway obstruction
030220 oncology & carcinogenesis
Female
business
Complication
Interventional bronchoscopy
Zdroj: Therapeutic Advances in Respiratory Disease
Therapeutic Advances in Respiratory Disease, Vol 14 (2020)
ISSN: 1753-4666
DOI: 10.1177/1753466620976012
Popis: Background: Hemorrhage is a life-threatening complication during bronchoscopic intervention in patients with central airway obstruction (CAO) due to metastatic renal cell carcinoma (RCC). Whether pre-bronchoscopic bronchial arterial embolization (BAE) can reduce the risk of severe bleeding in CAO patients due to metastatic RCC remains unclear. Methods: A total of 31 CAO patients due to metastatic RCC were included retrospectively and divided into a BAE group (receiving pre-bronchoscopic BAE) and non-BAE group in this study. Based on computed tomography (CT) and bronchoscopic findings, tumor debulking was used to reconstruct the airway during interventional bronchoscopy. The primary outcome was the incidence of severe bleeding during bronchoscopic procedures. Bleeding-related complications, Karnofsky performance score (KPS) and dyspnea score were also analyzed over a 1-month observation period. Results: There were no significant differences between the two groups in baseline characteristics, including patients’ features, tumor morphology under CT scannings, tumor site, and obstruction degree under bronchoscopic examination. Procedure-related bleeding occurred in all 31 patients. Pre-bronchoscopic BAE significantly reduced the incidence of moderate and major bleeding when compared with that in the non-BAE group. The incidence of poor visualization and hypoxia was also reduced significantly in the BAE group. There was no significant difference in KPS and dyspnea score between the BAE and non-BAE groups at 1 month follow up. Conclusion: Pre-bronchoscopic BAE might be a feasible option to reduce the risk of severe bleeding for CAO patients due to metastatic RCC during bronchoscopic intervention. Interventional bronchoscopy was a safe and effective procedure for CAO due to metastatic RCC. The reviews of this paper are available via the supplemental material section.
Databáze: OpenAIRE
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