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Alternative Therapies in Health and... Jul 2023The objective of this research study was to compare the safety and efficacy of bronchial artery embolization (BAE) using Embospheres alone versus Embospheres combined...
OBJECTIVE
The objective of this research study was to compare the safety and efficacy of bronchial artery embolization (BAE) using Embospheres alone versus Embospheres combined with gelfoam particles in patients with massive hemoptysis.
METHODS
A total of 127 patients with tuberculous massive hemoptysis who were scheduled to undergo BAE were recruited and divided into two groups: Embosphere group (E group, n = 57) and Embosphere combined with gelfoam particles group (E + G group, n = 70). Technical and clinical success were assessed after BAE surgery, and mortality, untoward reactions, and risk factors for clinical failure were recorded during follow-up.
RESULTS
The technical success rate was 92.99% in the E group and 97.14% in the E + G group (P = .272), with similar 1-year mortality rates of 1.76% and 2.86%, respectively (P = .684). However, the E group exhibited a lower clinical success rate compared to the E + G group (85.96% vs. 97.14%), and this difference was statistically significant (P = .020). The untoward reactions showed no statistically significant difference (all P > .05). Univariate analysis revealed that four factors were statistically significant: age (P = .028), presence of pulmonary cavity (P = .001), diabetes (P = .005), and a single use of Embosphere embolization (P = .020). Multivariate regression analysis demonstrated that embolization with Embosphere alone was a risk factor for clinical treatment failure (P = .025).
CONCLUSION
The combination of Embosphere with gelfoam particles can significantly improve the hemostatic effect of BAE without increasing the incidence of adverse reactions.
Topics: Humans; Gelatin Sponge, Absorbable; Hemoptysis; Bronchial Arteries; Gelatin; Embolization, Therapeutic; Treatment Outcome; Retrospective Studies
PubMed: 37083651
DOI: No ID Found -
Pneumologie (Stuttgart, Germany) Dec 2016
Topics: Bronchial Arteries; Bronchoscopy; Diagnosis, Differential; Embolization, Therapeutic; Female; Hemoptysis; Humans; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 27931072
DOI: 10.1055/s-0036-1596078 -
Turkish Journal of Medical Sciences Dec 2022A successful planning methodology for patients with hemoptysis promises overall improvement in patient care. Conducted in a reference center for chest diseases, the... (Observational Study)
Observational Study
BACKGROUND
A successful planning methodology for patients with hemoptysis promises overall improvement in patient care. Conducted in a reference center for chest diseases, the present study aims to analyze characteristics and predictors of interventional methods in patients with recurrent hemoptysis.
METHODS
The present study is a single-center, retrospective observational study. Between 2015 and 2018, 5973 patients with follow-up data until 2021 requiring more than one hospitalization due to recurrent hemoptysis were investigated. Patient characteristics, the amount of hemoptysis, baseline admission parameters, interventional procedures of bronchial artery embolization (BAE), fiberoptic bronchoscopy, rigid bronchoscopy, and surgical resections applied were analyzed according to number of hospitalizations and outcome.
RESULTS
: Hospital admission numbers were higher in patients with sequela of tuberculosis, bronchiectasis and lung cancer. While lung cancer was the most frequent underlying reason in recurrent admissions, it was determined that as the amount of bleeding increased, the number of admissions also increased to the hospital, and BAE and rigid bronchoscopy were performed more frequently in the groups with less frequent admissions. There was no statistically significance between the amount of bleeding, and the interventional procedure alone or in combination with another procedure (p > 0.05).
DISCUSSION
In conclusion, patients with certain diseases may experience frequent hospital admissions due to hemoptysis. Recurrent admissions may get better results with BAE and rigid bronchoscopy. We think that these procedures should be preferred in the foreground of suitable patient selection in line with available facilities and experience.
Topics: Humans; Hemoptysis; Hemorrhage; Bronchial Arteries; Bronchiectasis; Lung Neoplasms; Retrospective Studies; Treatment Outcome
PubMed: 36945984
DOI: 10.55730/1300-0144.5534 -
Journal of Vascular and Interventional... Jan 2022
Topics: Angiography; Bronchial Arteries; COVID-19; Hemoptysis; Humans; SARS-CoV-2
PubMed: 34980453
DOI: 10.1016/j.jvir.2021.08.020 -
Journal of Korean Medical Science May 2015Management of cryptogenic massive hemoptysis is difficult, and conservative treatment may be inadequate to stop the hemorrhage. Surgery is not a reasonable option...
Management of cryptogenic massive hemoptysis is difficult, and conservative treatment may be inadequate to stop the hemorrhage. Surgery is not a reasonable option because there is no underlying identifiable pathology. This study aimed to investigate the radiologic findings and bronchial artery embolization outcomes in cryptogenic hemoptysis, and to compare the results with non-cryptogenic hemoptysis. We evaluated 26 patients with cryptogenic hemoptysis and 152 patients with non-cryptogenic hemoptysis. A comparison of the bronchial artery abnormalities between the cryptogenic and non-cryptogenic hemoptysis groups showed that only extravasation was more statistically significant in the cryptogenic hemoptysis group than in the non-cryptogenic hemoptysis group, while the other bronchial artery abnormalities, such as bronchial artery dilatation, hypervascularity, and bronchial-to-pulmonary shunting, showed no significant difference between groups. Involvement of the non-bronchial systemic artery was significantly greater in the non-cryptogenic hemoptysis group than in the cryptogenic hemoptysis group. While 69.2% of patients with cryptogenic hemoptysis also had hypervascularity in the contralateral bronchial arteries and/or ipsilateral bronchial artery branches other than the bleeding lobar branches, this finding was not detected in non-cryptogenic hemoptysis. Embolization was performed on all patients using polyvinyl alcohol particles of 355-500 µm. Hemoptysis ceased in all patients immediately after embolization. While recurrence of hemoptysis showed no statistically significant difference between the cryptogenic and non-cryptogenic hemoptysis groups, it was mild in cryptogenic hemoptysis in contrast to mostly severe in non-cryptogenic hemoptysis. Transarterial embolization is a safe and effective technique to manage cryptogenic hemoptysis.
Topics: Adult; Bronchial Arteries; Bronchography; Case-Control Studies; Embolization, Therapeutic; Female; Hemoptysis; Hemorrhage; Humans; Male; Middle Aged; Recurrence; Tomography, X-Ray Computed
PubMed: 25931790
DOI: 10.3346/jkms.2015.30.5.591 -
European Review For Medical and... Jan 2021To detect the expressions of tumor necrosis factor-α-induced protein-8-like 2 (TIPE2) and tissue factor (TF) in peripheral blood mononuclear cells (PBMCs) of patients...
Changes in expressions of TIPE2 and TF in peripheral blood mononuclear cells of patients with acute exacerbation of bronchial asthma and their associations with changes in inflammatory factors and T lymphocytes.
OBJECTIVE
To detect the expressions of tumor necrosis factor-α-induced protein-8-like 2 (TIPE2) and tissue factor (TF) in peripheral blood mononuclear cells (PBMCs) of patients with acute exacerbation of bronchial asthma (BA), and to analyze their associations with changes in inflammatory factors and T lymphocytes.
PATIENTS AND METHODS
A total of 59 patients with BA treated in our hospital from February 2018 to April 2019 were selected as objects, including 30 cases in the acute exacerbation phase (BA group) and 29 in the remission phase (RE group). During the same period, 28 people receiving physical examinations were selected as healthy controls (Control group). The proportion of eosinophils in the sputum and the fractional exhaled nitric oxide (FeNO) level were detected in each subject. Blood samples were collected in patients of BA group and Control group, aiming to isolate PBMCs. Then, the messenger RNA (mRNA) expressions of TIPE2 and TF in PBMCs were determined via reverse transcription-polymerase chain reaction (RT-PCR). Serum levels of interleukin-1β (IL-1β) and IL-6 in BA group and Control group were determined via enzyme-linked immunosorbent assay (ELISA), and protein expressions of serum T helper 1 (Th1) and Th2 cells in BA group and Control group were detected using Western blotting.
RESULTS
Compared with those in Control group, the proportion of eosinophils and FeNO level increased in BA and RE group, which were more pronounced in BA group. Downregulated mRNA level of TIPE2, and upregulated TF were detected in BA and RE groups compared to those of Control group, and the expression changes were more significant in the former group. Enzyme-linked immunosorbent assay (ELISA) data showed that serum levels of IL-1β and IL-6 were significantly elevated in BA and RE groups in comparison to Control group, especially BA group. In addition, protein level of Th1 cells was downregulated, while that of Th2 was upregulated in BA group and RE group compared to those of Control group, and a more significant change was observed in BA group compared to that of RE group.
CONCLUSIONS
In patients with acute exacerbation of BA, the expression of TIPE2 in PBMCs declined, while that of TF rose, which were negatively correlated with each other. Moreover, the proportion of Th1 cells declined in patients with acute exacerbation of BA, indicating that it is associated with the lung function, inflammatory level and proportion of eosinophils.
Topics: Acute Disease; Adult; Aged; Asthma; Female; Humans; Interleukin-1beta; Interleukin-6; Intracellular Signaling Peptides and Proteins; Leukocytes, Mononuclear; Male; Middle Aged; Th1 Cells; Thromboplastin
PubMed: 33506909
DOI: 10.26355/eurrev_202101_24386 -
BMJ Case Reports Apr 2014A 40-year-old homeless woman who was a known intravenous drug user and heroin smoker, presented with massive haemoptysis. Initial CT-pulmonary angiogram (CT-PA) did not...
A 40-year-old homeless woman who was a known intravenous drug user and heroin smoker, presented with massive haemoptysis. Initial CT-pulmonary angiogram (CT-PA) did not show active haemorrhage but found an opacity in a right upper lobe cavity likely to represent a mycetoma. She was started on antifungal therapy but haemoptysis persisted and bronchial angiography was performed. Again no active haemorrhage was identified but abnormal vasculature was seen supplying the right upper lobe. This was empirically embolised with particles which did not improve her symptoms. A subsequent CT-PA identified a pulmonary artery pseudoaneurysm in the cavity wall which was successfully embolised. There was no further haemoptysis and a repeat CT-PA 3 weeks later showed continuing occlusion of the pulmonary artery aneurysm. Investigations for tuberculosis were negative and she was discharged clinically well and on long-term antifungal therapy.
Topics: Adult; Aneurysm, False; Angiography; Antifungal Agents; Embolization, Therapeutic; Female; Hemoptysis; Ill-Housed Persons; Humans; Mycetoma; Pulmonary Artery; Pulmonary Aspergillosis; Pyrimidines; Severity of Illness Index; Substance Abuse, Intravenous; Tomography, X-Ray Computed; Triazoles; Voriconazole
PubMed: 24739651
DOI: 10.1136/bcr-2013-200019 -
RoFo : Fortschritte Auf Dem Gebiete Der... Nov 2016The aim of the study was to evaluate safety, effectiveness, recurrence rate and 10-year survival after bronchial artery embolization (BAE) in benign and malignant...
The aim of the study was to evaluate safety, effectiveness, recurrence rate and 10-year survival after bronchial artery embolization (BAE) in benign and malignant etiologies. The retrospective study includes 100 BAE procedures in 88 patients. Underlying disease was classified as benign (n = 67) and malignant (n = 21) etiologies. Immediate bleeding control and procedure safety were evaluated in all patients. In 51 (58 %) patients, follow-up data with a median follow-up time of 1015 days (range, 494 to 3727 days) were acquired to assess overall survival, time-to-recurrence of bleeding and recurrence-free survival, using Kaplan-Maier estimates to compare differences between both subgroups. Immediate bleeding control was achieved after 96/100 procedures (96 %), with a minor complication rate of 5.0 %. No major complications occurred. The overall survival was 74 % after 1 year and 59 % after 5 years and 10 years. There was a significant difference in survival between the malignant and benign groups (p < 0.0001). Survival was 90 %, 80 % and 76 % at 1 year, 3 years and 10 years, respectively, in the benign group and 18 % and 0 % at 1 year and 3 years, respectively in the malignant group. The median time to recurrence of bleeding and recurrence-free survival were 239 days and 94 % after 1 year and 87 % after 10 years in the benign group, compared to 66 days and 34 % after 1 year and 0 % after 3 years in the malignant group (p = 0.0107). BAE is a safe and highly effective treatment option in hemoptysis. However, the recurrence rate and survival are highly dependent on the underlying disease. • BAE is a safe and highly effective treatment option in hemoptysis.• Recurrence rate and survival are strongly dependent on the underlying disease with significantly impaired results in patients with malignant diseases. • Coil embolization is an effective BAE treatment method. Nevertheless, it should be mentioned, that reinterventions can be impeded, if embolization is performed in the proximal part of bronchial arteries. • Syha R, Benz T, Hetzel J et al. Bronchial Artery Embolization in Hemoptysis: 10-Year Survival and Recurrence-Free Survival in Benign and Malignant Etiologies - A Retrospective Study. Fortschr Röntgenstr 2016; 188: 1061 - 1066.
Topics: Adult; Aged; Brachial Artery; Disease-Free Survival; Embolization, Therapeutic; Germany; Hemoptysis; Hemostatics; Humans; Longitudinal Studies; Lung Neoplasms; Middle Aged; Prevalence; Recurrence; Retrospective Studies; Risk Factors; Survival Rate; Treatment Outcome
PubMed: 27760440
DOI: 10.1055/s-0042-112227 -
European Radiology Jul 2021Patients with haemoptysis often experience daily physical and mental impairment. Bronchial artery embolisation is among the first-line treatment options used worldwide;... (Observational Study)
Observational Study
OBJECTIVES
Patients with haemoptysis often experience daily physical and mental impairment. Bronchial artery embolisation is among the first-line treatment options used worldwide; however, no evidence exists regarding the health-related quality of life (HRQoL) after bronchial artery embolisation. Therefore, this study aimed to evaluate the effects of bronchial artery embolisation on the HRQoL of patients with haemoptysis.
METHODS
We prospectively enrolled 61 consecutive patients who visited our hospital from July 2017 to August 2018 and received bronchial artery embolisation for haemoptysis. The primary outcome was the HRQoL evaluated using the Short Form Health Survey, which contains physical and mental components, before and after bronchial artery embolisation. The secondary outcomes were procedural success, complications, and recurrence-free survival rate at 6 months.
RESULTS
The mean age of the patients was 69 years (range, 31-87 years). The procedural success rate was 98%. No major complications occurred. The recurrence-free survival rate estimated using the Kaplan-Meier analysis at 6 months after bronchial artery embolisation was 91.8% (95% confidence interval, 91.1-92.5%). Compared with the pre-treatment scores, the physical and mental scores were significantly improved at 6 months after bronchial artery embolisation (p < 0.05).
CONCLUSION
Bronchial artery embolisation improved the HRQoL of patients with haemoptysis.
KEY POINTS
• Bronchial artery embolisation improved the HRQoL of patients with haemoptysis. • Vessel dilation on computed tomography and systemic artery-pulmonary artery direct shunting on angiography were the most common abnormalities. • The recurrence-free survival rate estimated using the Kaplan-Meier analysis at 6 months after bronchial artery embolisation was 91.8%.
Topics: Adult; Aged; Aged, 80 and over; Bronchial Arteries; Embolization, Therapeutic; Hemoptysis; Humans; Middle Aged; Quality of Life; Retrospective Studies; Treatment Outcome
PubMed: 33409794
DOI: 10.1007/s00330-020-07533-x -
Respiratory Medicine 2022In many patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH), bronchial artery hypertrophy is observed. Patients with bronchial dilatation have been shown...
INTRODUCTION
In many patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH), bronchial artery hypertrophy is observed. Patients with bronchial dilatation have been shown to be at increased risk of hemoptysis introducing the risk of airway obstruction. In this study from an academic tertiary referral center, we aimed to assess the incidence of massive hemoptysis in our CTEPH patients, the success of bronchial artery embolization (BAE), recurrence, and hemoptysis-related mortality.
METHODS
Retrospective cohort study of all adults with CTEPH who underwent BAE for massive hemoptysis between 1 January 2015 and 30 July 2021. Primary endpoints were hemoptysis relapse and hemoptysis-related mortality.
RESULTS
There were 367 patients who were being treated and managed with a diagnosis of CTEPH at our institution. There were 24 bronchial artery embolization procedures performed for all causes. A total of 3 patients during this time met inclusion criteria with acute massive hemoptysis and CTEPH. All patients were taking therapeutic-dose anticoagulation. Technical success after BAE was 100%. No hemoptysis recurrence was demonstrated at 17, 24, and 40-months follow-up respectively. No patient died from hemoptysis. However, 1 patient died 24 months after the embolization procedure due to a non-hemoptysis cause.
CONCLUSION
This study highlights the low but important incidence of massive hemoptysis in patients with CTEPH. Unlike other causes of hemoptysis, this unique cohort requires balancing anticoagulation and hemorrhage control. Given the high degree of success, BAE is a viable option, allowing continuation or early re-establishment of anticoagulation.
Topics: Adult; Bronchial Arteries; Embolization, Therapeutic; Hemoptysis; Humans; Hypertension, Pulmonary; Recurrence; Retrospective Studies; Treatment Outcome
PubMed: 35232634
DOI: 10.1016/j.rmed.2022.106784