Bhalla Ashu, Kandasamy Devasenathipathy, Veedu Prasad, Mohan Anant, Gamanagatti Shivanand
Department of Radiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Oman Med J. 2015 Mar;30(2):119-28. doi: 10.5001/omj.2015.26.
To analyze the safety and efficacy of bronchial artery embolization (BAE) in the management of hemoptysis.
We conducted a retrospective study of 334 patients who had undergone BAE for hemoptysis from January 2007 to July 2013. Our study included 255 (76.3%) males and 79 (23.7%) females with an age range from five to 81 years old. All relevant arteries were evaluated but only those arteries that showed hypertrophy and significant blush were targeted. Polyvinyl alcohol (PVA) was used in all patients and gel foam was used in combination with PVA where there was significant shunting.
Mild hemoptysis was seen in 70 patients, moderate in 195 patients, and severe in 69 patients. On imaging, right side disease was seen in 101 patients, left side involvement in 59 patients, and bilateral involvement in 174 patients. Post-tubercular changes were the predominant pathology seen in 248 patients. Among 334 patients (386 procedures), 42 patients underwent the procedure twice and five patients underwent the procedure thrice. A total of 485 arteries were attempted of which 440 arteries were successfully embolized. Right intercosto-bronchial was the most common culprit artery present in 157 patients, followed by common bronchial (n=97), left bronchial (n=55), and right bronchial (n=45). We embolized a maximum of four arteries in one session. Immediate complications such as dissection and rupture occurred in only nine sessions (2.3%). Twenty-five procedures (6.5%) were repeated within two months, which were due to technical or clinical failure and 27 procedures (7%) were repeated after two months.
BAE is a safe and effective procedure with a negligible complication rate. Our approach of targeting hypertrophied arteries was effective.
分析支气管动脉栓塞术（BAE）治疗咯血的安全性和有效性。
我们对2007年1月至2013年7月期间接受BAE治疗咯血的334例患者进行了回顾性研究。我们的研究包括255例（76.3%）男性和79例（23.7%）女性，年龄范围为5至81岁。对所有相关动脉进行了评估，但仅针对那些显示肥大和明显造影剂外溢的动脉。所有患者均使用聚乙烯醇（PVA），在存在明显分流的情况下，将明胶海绵与PVA联合使用。
70例患者出现轻度咯血，195例患者出现中度咯血，69例患者出现重度咯血。影像学检查显示，101例患者右侧患病，59例患者左侧受累，174例患者双侧受累。结核后改变是248例患者中最主要的病理表现。在334例患者（386次手术）中，42例患者接受了两次手术，5例患者接受了三次手术。总共尝试栓塞485条动脉，其中440条动脉成功栓塞。右肋间支气管是157例患者中最常见的责任动脉，其次是共同支气管（n = 97）、左支气管（n = 55）和右支气管（n = 45）。我们在一次手术中最多栓塞四条动脉。仅9次手术（2.3%）出现了诸如夹层和破裂等即刻并发症。25次手术（6.5%）在两个月内重复进行，这是由于技术或临床失败，27次手术（7%）在两个月后重复进行。
BAE是一种安全有效的手术，并发症发生率可忽略不计。我们针对肥大动脉的方法是有效的。
