Pathak Vikas, Stavas Joseph M, Ford Hubert J, Austin Charles A, Aris Robert M
Department of Pulmonary Disease and Critical Care Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Department of Interventional Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Lung India. 2016 Jan-Feb;33(1):3-8. doi: 10.4103/0970-2113.173059.
Bronchial artery embolization (BAE) is an established, safe, and effective procedure for the treatment of hemoptysis but long-term outcomes of the BAE have never been investigated before.
To retrospectively analyze long-term outcomes of the BAE.
A retrospective chart analysis was done from the hospital central database for all patients undergoing the BAE over a consecutive 14-year period (January 2000-February 2014). A total of 58 patients were identified from the database. Eight patients were excluded due to the lack of follow-up. Data such as patient demographics, reason for hemoptysis, medical imaging results, bronchoscopy findings, recurrence rates, and morbidity/mortality rates after the BAE were collected.
Eighty three embolizations were performed in 50 patients. The median follow-up was of 2.2 years. Cystic fibrosis (CF) bronchiectasis was the most common etiology (21/50), followed by non-CF bronchiectasis (9/50). Cavitary lung disease occurred in 12/50 patients, an additional 4/50 had cancer (primary lung and metastatic), and one patient had antineutrophil cytoplasmic antibody (ANCA) vasculitis. In three patients the etiology was unknown. Postprocedural complications occurred in 5/83 (6%) patients, two patients with two major complications - stroke (one) and paraplegia (one) - and three patients with minor complications - chest pain (two) and bronchial artery dissection (one). A total of 15/50 patients died during the follow-up. Three patients died of hemoptysis, and the remaining deaths were unrelated to the procedure or hemoptysis. Twenty four patients had recurrent hemoptysis. A Kaplan-Meier analysis revealed an excellent long-term survival that was 85% at 10 years.
The BAE is a safe and effective procedure with excellent overall long-term survival.
支气管动脉栓塞术（BAE）是一种成熟、安全且有效的咯血治疗方法，但此前从未对BAE的长期疗效进行过研究。
回顾性分析BAE的长期疗效。
对医院中央数据库中连续14年（2000年1月至2014年2月）接受BAE治疗的所有患者进行回顾性病历分析。从数据库中识别出58例患者。8例患者因缺乏随访而被排除。收集患者人口统计学数据、咯血原因、医学影像结果、支气管镜检查结果、复发率以及BAE后的发病率/死亡率等数据。
50例患者共进行了83次栓塞。中位随访时间为2.2年。囊性纤维化（CF）支气管扩张是最常见的病因（21/50），其次是非CF支气管扩张（9/50）。12/50例患者出现空洞性肺病，另外4/50例有癌症（原发性肺癌和转移性癌），1例患者患有抗中性粒细胞胞浆抗体（ANCA）血管炎。3例患者病因不明。术后并发症发生在5/83（6%）例患者中，2例患者出现两种主要并发症——中风（1例）和截瘫（1例），3例患者出现轻微并发症——胸痛（2例）和支气管动脉夹层（1例）。随访期间共有15/50例患者死亡。3例患者死于咯血，其余死亡与手术或咯血无关。24例患者出现咯血复发。Kaplan-Meier分析显示长期生存率良好，10年时为85%。
BAE是一种安全有效的手术，总体长期生存率良好。
