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Bronchial and nonbronchial systemic artery embolization in managing haemoptysis: 31 years of experience

Embolizzazione delle arterie bronchiali e/o sistemiche non bronchiali nel controllo dell’emottisi: 31 anni d’esperienza

  • Vascular and Interventional Radiology / Radiologia Vascolare e Interventistica
  • Published:
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Abstract

Purpose

The authors report on 31 years of experience with bronchial (BAE) and/or nonbronchial (NBAE) systemic artery embolisation for managing haemoptysis.

Materials and methods

A total of 534 patients who underwent bronchial artery angiography for haemoptysis between 1979 and 2010 were retrospectively evaluated. Of these patients, 477 (89%) had active bleeding and underwent BAE and/or NBAE (295 males and 182 females, aged between 12 and 71 years). Embolisation techniques, materials, major and minor complications and relapses were recorded.

Results

Complete resolution of haemoptysis was achieved within 24 h in 458/477 (96%) cases and within 48 h in 2% of cases. The aetiology of haemoptysis was as follows: cystic fibrosis (23%), bronchiectasis (13%), tuberculosis sequelae (8%), chronic obstructive pulmonary disease (COPD) (6%) and no apparent cause (21%). Major complications were recorded in 3/477 (0.6%): stroke (n=1), transient ischaemic attack (TIA) (n=1) and transient quadriplegia (n=1). Minor complications were recorded in 143/477 (30%): chest pain 86/143 (60%) and dysphagia 29/143 (20%). During a mean follow-up period of 14 (8–36) months, haemoptysis recurrence was observed in 42/110 cases (38%) of cystic fibrosis and in 77/367 cases of other diseases (21%).

Conclusions

BAE and NBAE are effective and safe for acute treatment of haemoptysis, with low recurrence and complication rates. Interventional radiologist experience is crucial to the successful haemoptysis control and preventing complications.

Riassunto

Obiettivo

Scopo del nostro lavoro è riportare l’esperienza di 31 anni nell’embolizzazione delle arterie bronchiali (BAE) e/o sistemiche non bronchiali (NBAE) nel controllo dell’emottisi.

Materiali e metodi

Dal 1979 al 2010, 534 pazienti sottoposti ad angiografia delle arterie bronchiali per emottisi sono stati retrospettivamente valutati; 477 (89%) avevano sanguinamento attivo e hanno eseguito BAE e/o NBAE (295 maschi e 182 femmine, etá compresa tra 12 e 71 anni). Sono state riportate tecniche di embolizzazione, materiali impiegati, complicanze maggiori e minori e recidive.

Risultati

Quattrocentocinquantotto/477 (96%) dei casi presentarono risoluzione completa dell’emottisi entro 24 ore, 2% entro 48 ore. L’eziologia dell’emottisi è stata fibrosi cistica (23%), bronchiectasie (13%), esiti tubercolari (8%), broncopneumopatia cronica ostruttiva (BPCO) (6%) e sine materia (21%). Tre/477 (0,6%) pazienti presentarono complicanze maggiori: ictus cerebrale (1), attacco ischemico transiente (TIA) (1) e tetraparesi transitoria (1); 143/477 (30%) presentarono complicanze minori: dolore toracico 86/143 (60%) e disfagia 29/143 (20%). Il follow-up medio fu di 14 mesi (8–36 mesi), recidiva di emottisi nella fibrosi cistica 42/110 (38%) e nelle altre patologie 77/367 (21%).

Conclusioni

La BAE e NBAE sono tecniche efficaci e sicure nel trattamento acuto dell’emottisi, con bassa percentuale di recidive e complicanze. L’esperienza del radiologo interventista è un fattore molto importante nel successo del controllo dell’emottisi e nella prevenzione delle complicanze.

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References/Bibliografia

  1. Ferris EJ (1981) Pulmonary hemorrhage. Vascular evaluation and interventional therapy. Chest 80:710–714

    Article  PubMed  CAS  Google Scholar 

  2. Marshall TJ, Jackson JE (1997) Vascular intervention in the thorax: bronchial artery embolization for haemoptysis. Eur Radiol 7:1221–1227

    Article  PubMed  CAS  Google Scholar 

  3. Yoon W, Kim JK, Kim YH et al (2002) Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: a comprehensive review. Radiographics 22:1395–1409

    Article  PubMed  Google Scholar 

  4. Fernando HC, Stein M, Benfield JR, Link DP (1998) Role of bronchial artery embolization in the management of hemoptysis. Arch Surg 133:862–866

    Article  PubMed  CAS  Google Scholar 

  5. Hirshberg B, Biran I, Glazer M, Kramer MR (1997) Hemoptysis: etiology, evaluation, and outcome in a tertiary referral hospital. Chest 112:440–444

    Article  PubMed  CAS  Google Scholar 

  6. Jean-Baptiste E (2000) Clinical assessment and management of massive hemoptysis. Crit Care Med 28:1642–1647

    Article  PubMed  CAS  Google Scholar 

  7. Cornalba G, Rota L, Barazzoni G et al (1986) Bronchial embolization in the prevention of hemoptysis caused by cystic fibrosis. Radiol Med 72:720–723

    PubMed  CAS  Google Scholar 

  8. Brown MD, Vance SJ, Kline JA (2005) An emergency department guideline for the diagnosis of pulmonary embolism: an outcome study. Acad Emerg Med 12:20–25

    Article  PubMed  Google Scholar 

  9. Bruzzi JF, Remy-Jardin M, Delhaye D et al (2006) Multi-detector row CT of hemoptysis. Radiographics 26:3–22

    Article  PubMed  Google Scholar 

  10. Hiyama J, Horita N, Shiota Y et al (2002) Cryptogenic hemoptysis and smoking. Chest 121:1375–1376

    Article  PubMed  Google Scholar 

  11. Haponik EF, Fein A, Chin R (2000) Managing life-threatening hemoptysis: has anything really changed? Chest 118:1431–1435

    Article  PubMed  CAS  Google Scholar 

  12. Deffebach ME, Charan NB, Lakshminarayan S, Butler J (1987) The bronchial circulation. Small, but a vital attribute of the lung. Am Rev Respir Dis 135:463–481

    PubMed  CAS  Google Scholar 

  13. Malik AB, Tracy SE (1980) Bronchovascular adjustments after pulmonary embolism. J Appl Physiol 49:476–48

    PubMed  CAS  Google Scholar 

  14. Remy J, Arnaud A, Fardou H et al (1977) Treatment of hemoptysis by embolization of bronchial arteries. Radiology 122:33–37

    PubMed  CAS  Google Scholar 

  15. Remy J, Voisin C, Ribet M et al (1973) Treatment, by embolization, of severe or repeated hemoptysis associated with systemic hypervascularization. Nouv Presse Med 2:2060

    PubMed  CAS  Google Scholar 

  16. Barben J, Robertson D, Olinsky A, Ditchfield M (2002) Bronchial artery embolization for hemoptysis in young patients with cystic fibrosis. Radiology 224:124–130

    Article  PubMed  Google Scholar 

  17. Vidal V, Therasse E, Berthiaume Y et al (2006) Bronchial artery embolization in adults with cystic fibrosis: impact on the clinical course and survival. J Vasc Interv Radiol 17:953–958

    Article  PubMed  Google Scholar 

  18. Hsiao EI, Kirsch CM, Kagawa F et al (2001) Utility of fiberoptic bronchoscopy before bronchial artery embolization for massive hemoptysis. AJR Am Roentgenol 177:861–867

    Article  CAS  Google Scholar 

  19. Anuradha C, Shyamkumar NK, Vinu M et al (2012) Outcomes of bronchial artery embolization for life-threatening hemoptysis due to tuberculosis and post-tuberculosis sequelae. Diagn Interv Radiol 18:96–101

    PubMed  Google Scholar 

  20. Chung MJ, Lee JH, Lee KS et al (2006) Bronchial and nonbronchial systemic arteries in patients with hemoptysis: depiction on MDCT angiography. AJR Am J Roentgenol 186:649–655

    Article  PubMed  Google Scholar 

  21. Hartmann IJ, Remy-Jardin M, Menchini L et al (2007) Ectopic origin of bronchial arteries: assessment with multidetector helical CT angiography. Eur Radiol 17:1943–1953

    Article  PubMed  Google Scholar 

  22. Wong ML, Szkup P, Hopley MJ (2002) Percutaneous embolotherapy for life-threatening hemoptysis. Chest 121:95–102

    Article  PubMed  Google Scholar 

  23. Tanaka N, Yamakado K, Murashima S et al (1997) Superselective bronchial artery embolization for hemoptysis with a coaxial microcatheter system. J Vasc Interv Radiol 8:65–70

    Article  PubMed  CAS  Google Scholar 

  24. Mal H, Rullon I, Mellot F et al (1999) Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Chest 115:996–1001

    Article  PubMed  CAS  Google Scholar 

  25. Nistri M, Acquafresca M, Pratesi A et al (2008) Bronchial artery embolization with detachable coils for the treatment of haemoptysis. Preliminary experience. Radiol Med 113:452–460

    Article  PubMed  CAS  Google Scholar 

  26. Herth F, Ernst A, Becker HD (2001) Long-term outcome and lung cancer incidence in patients with hemoptysis of unknown origin. Chest 120:1592–1594

    Article  PubMed  CAS  Google Scholar 

  27. Remy-Jardin M, Bouaziz N, Dumont P et al (2004) Bronchial and nonbronchial systemic arteries at multi-detector row CT angiography: comparison with conventional angiography. Radiology 233:741–749

    Article  PubMed  Google Scholar 

  28. Crocco JA, Rooney JJ, Fankushen DS et al (1968) Massive hemoptysis. Arch Intern Med 121:495–498

    Article  PubMed  CAS  Google Scholar 

  29. Dweik RA, Stoller JK (1999) Role of bronchoscopy in massive hemoptysis. Clin Chest Med 20:89–105

    Article  PubMed  CAS  Google Scholar 

  30. Kalva SP (2009) Bronchial artery embolization. Tech Vasc Interv Radiol 12:130–138

    Article  PubMed  Google Scholar 

  31. Duncan M, Wijesekera N, Padley S (2010) Interventional radiology of the thorax. Respirology 15:401–412

    Article  PubMed  Google Scholar 

  32. Pump KK (1972) Distribution of bronchial arteries in the human lung. Chest 62:447–451

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Dipartimento di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano, Ospedale San Paolo, Via di Rudini 8, 20142, Milano, Italy

    G.P. Cornalba, A. Vella, F. Barbosa, G. Greco, C. Michelozzi, A. Sacrini & F. Melchiorre

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  1. G.P. Cornalba
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  2. A. Vella
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  3. F. Barbosa
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  4. G. Greco
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  5. C. Michelozzi
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  6. A. Sacrini
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  7. F. Melchiorre
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Correspondence to F. Barbosa.

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Cornalba, G., Vella, A., Barbosa, F. et al. Bronchial and nonbronchial systemic artery embolization in managing haemoptysis: 31 years of experience. Radiol med 118, 1171–1183 (2013). https://doi.org/10.1007/s11547-012-0866-y

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  • DOI: https://doi.org/10.1007/s11547-012-0866-y

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