Rasciti Edoardo, Sverzellati Nicola, Silva Mario, Casadei Andrea, Attinà Domenico, Palazzini Massimiliano, Galiè Nazzareno, Zompatori Maurizio
Division of Radiology, Department of Surgical Sciences, University of Parma, Parma, Italy.
Cardiothoracic Radiology Unit, Cardio-Thoracic-Vascular Department, University Hospital S.Orsola-Malpighi, Bologna, Italy.
Radiol Med. 2017 Apr;122(4):257-264. doi: 10.1007/s11547-016-0714-6. Epub 2016 Dec 26.
To test the efficacy of bronchial artery embolization (BAE) to treat haemoptysis in pulmonary hypertension (PH).
33 patients were treated by BAE for haemoptysis associated with PH (PH group = 21) or non-associated with PH (control group = 12). The details of procedure, outcome, and rate of relapse were compared between the two groups. Within the PH group, the comparison was operated between subjects with congenital heart disease-associated pulmonary artery hypertension (CHD-APAH subgroup = 12) and non-CHD (non-CHD-APAH subgroup = 9).
The rate of relapse at 30 and 90-days was similar between the PH group and control group. BAE in the PH group was more challenging (median 2 arteries embolized per procedure) compared to the control group (median 1 artery embolized per procedure; p = 0.001). Bleeding arteries were more heterogeneous in the PH group, while a single right bronchial artery was the only clinical finding in 66.7% of controls (p = 0.001). Within the PH group, the CHD subgroup showed higher survival rate compared to the non-CHD-APAH group (p = 0.007).
BAE is effective and safe for the treatment of haemoptysis in PH, yet more challenging than other conditions. In PH-associated haemoptysis, BAE provides higher survival rate for subjects with PH associated with CHD.
测试支气管动脉栓塞术（BAE）治疗肺动脉高压（PH）合并咯血的疗效。
33例咯血患者接受了BAE治疗，其中合并PH的患者21例（PH组），不合并PH的患者12例（对照组）。比较两组的手术细节、治疗结果和复发率。在PH组中，对先天性心脏病相关性肺动脉高压患者（CHD-APAH亚组=12例）和非CHD患者（非CHD-APAH亚组=9例）进行了比较。
PH组和对照组30天及90天的复发率相似。与对照组相比，PH组的BAE操作更具挑战性（每次手术栓塞的动脉中位数为2条），而对照组为1条（p=0.001）。PH组出血动脉的情况更复杂，而66.7%的对照组患者唯一的临床发现是单一的右支气管动脉（p=0.001）。在PH组中，CHD亚组的生存率高于非CHD-APAH组（p=0.007）。
BAE治疗PH合并咯血有效且安全，但比其他情况更具挑战性。在PH相关性咯血中，BAE为CHD相关性PH患者提供了更高的生存率。
