Division of Pulmonary and Critical Care, Department of Medicine, University of Washington, Seattle, WA.
Department of Radiology, Seattle Childrens, Seattle, WA.
Chest. 2016 Oct;150(4):e93-e98. doi: 10.1016/j.chest.2016.03.009.
Cystic fibrosis (CF) patients are at risk for life-threatening hemoptysis, sometimes necessitating bronchial arterial embolization (BAE). Spinal artery embolization and pulmonary infarction are commonly cited procedural risks, yet respiratory failure and death are underappreciated. We conducted a retrospective institutional review of our outcomes after BAE for hemoptysis in CF and present three cases highlighting this complication. From 2007 to 2015, 12 patients underwent 17 BAE procedures for hemoptysis at our institution. Three patients experienced respiratory failure and died within 3 months of BAE. Nonsurvivors had significantly lower baseline FEV values than survivors (21.8% vs 52.6%, P < .05). BAE as a treatment for life-threatening hemoptysis may precipitate respiratory failure in end-stage CF and should accelerate the evaluation for lung transplantation. Institutions should reevaluate their BAE practices to ensure preservation of the bronchial circulation, which contributes to gas exchange in these patients.
囊性纤维化 (CF) 患者有发生危及生命的咯血的风险，有时需要进行支气管动脉栓塞术 (BAE)。脊髓动脉栓塞和肺梗死是常见的程序风险，但呼吸衰竭和死亡的风险被低估了。我们对我院 CF 患者因咯血而行 BAE 的结果进行了回顾性机构审查，并提出了三个突出这一并发症的病例。2007 年至 2015 年，我院 12 例患者因咯血行 17 次 BAE 治疗。3 例患者在 BAE 后 3 个月内发生呼吸衰竭并死亡。非幸存者的基础 FEV 值明显低于幸存者 (21.8%比 52.6%，P<.05)。BAE 作为治疗危及生命的咯血的方法可能会在 CF 晚期引发呼吸衰竭，应加速进行肺移植评估。各机构应重新评估其 BAE 实践，以确保支气管循环的保留，这有助于这些患者的气体交换。
