Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; CibeRes - Ciber de Enfermedades Respiratorias, Bunyola, Mallorca, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España.
Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España.
Arch Bronconeumol. 2014 Feb;50(2):51-6. doi: 10.1016/j.arbres.2013.06.003. Epub 2013 Aug 7.
Artery embolization (AE) is a safe and useful procedure in the management of massive hemoptysis. The objective of our study was to describe the experience of AE in a tertiary referral center, to characterize angiographic findings at the time of recurrence, and to analyze factors associated with these findings.
Observational retrospective study of patients presenting with life-threatening hemoptysis. All consecutive patients with at least one episode of hemoptysis that required AE during a 13-year period were included. The effects of i)time to recurrence; ii)use of coils, and iii)number of arteries embolized on the likelihood that the recurrence was secondary to recanalization were assessed.
One hundred seventy-six patients were included in the study. Twenty-two patients (12.5%) died due to hemoptysis. Probability of recurrence-free survival at one month was 0.91 (95%CI: 0.87 to 0.95), at 12months was 0.85 (95%CI: 0.79 to 0.91), and after 3 years was 0.75 (95%CI: 0.66 to 0.83). A longer time to recurrence was associated with a higher probability that the hemorrhage affected the same artery (estimate=0.0157, z-value=2.41, p-value=0.016).
AE is a safe and useful technique in the management of massive and recurrent hemoptysis. Nevertheless, recurrence after embolization is not uncommon. Recurring hemoptysis due to recanalization is related to time to recurrence, but not to the use of coils or number of arteries embolized.
动脉栓塞术（AE）在大咯血的治疗中是一种安全且有效的方法。我们的研究目的是描述在三级转诊中心进行 AE 的经验，描述复发性咯血时的血管造影表现，并分析与这些表现相关的因素。
对因大咯血危及生命而就诊的患者进行观察性回顾性研究。所有在 13 年内至少发生过一次需要进行 AE 治疗的咯血发作的连续患者均被纳入研究。评估了以下因素对复发的影响：i）复发时间；ii）使用线圈的情况，以及 iii）栓塞的动脉数量。
本研究共纳入 176 例患者。22 例（12.5%）患者因咯血死亡。术后 1 个月、12 个月和 3 年无复发生存率分别为 0.91（95%CI：0.87 至 0.95）、0.85（95%CI：0.79 至 0.91）和 0.75（95%CI：0.66 至 0.83）。复发时间越长，同一动脉再次出血的可能性越大（估计值=0.0157，z 值=2.41，p 值=0.016）。
AE 是治疗大咯血和复发性咯血的安全有效的技术。然而，栓塞后复发并不少见。再出血是由于血管再通引起的，与复发时间有关，而与线圈的使用或栓塞的动脉数量无关。
