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使用液体栓塞剂乙烯-乙烯醇共聚物经支气管动脉栓塞治疗急性咯血

Treatment of Acute Hemoptysis by Bronchial Artery Embolization with the Liquid Embolic Agent Ethylene Vinyl Alcohol Copolymer.

作者信息

Ayx Isabelle, Müller-Wille René, Wohlgemuth Walter A, Pfeifer Michael, Lepiorz Marc, Hubauer Heinrich, Goessmann Holger, Stroszczynski Christian, Zorger Niels

机构信息

Departments of Radiology, Barmherzige Brüder Regensburg, Regensburg, Germany.

Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.

出版信息

J Vasc Interv Radiol. 2017 Jun;28(6):825-831. doi: 10.1016/j.jvir.2016.12.1226. Epub 2017 Mar 6.

Abstract

PURPOSE

To determine the technical and clinical success of bronchial artery embolization (BAE) with the liquid embolic agent ethylene vinyl alcohol (EVOH) copolymer in patients with acute hemoptysis.

MATERIALS AND METHODS

Thirty-four patients (25 male; mean age, 58 y; range, 13-78 y) who underwent BAE with EVOH were retrospectively reviewed. Reasons for acute hemoptysis included lung cancer (44%), pulmonary metastases (12%), bronchiectasis (21%), arteriovenous malformation (5%), tuberculosis (6%), aspergilloma (3%), acute respiratory distress syndrome (3%), anticoagulant overdose (3%), and scar tissue (3%). Technical and clinical success of BAE were retrospectively assessed.

RESULTS

Embolization was technically successful in 94% of patients. Additional embolization material was needed in 4 patients (12%). The immediate clinical success rate was 94% (32 of 34); in 2 patients (6%), hemoptysis recurred immediately after the intervention or could not be stopped. Periinterventional minor complications included headache (n = 1), fever (n = 1), and acute renal failure (n = 1). During follow-up (mean, 8.8 mo), 5 patients had a recurrence of hemoptysis (15%).

CONCLUSIONS

The use of EVOH copolymer for BAE in patients with acute hemoptysis is technically successful and safe and has a good clinical outcome with a low number of recurrences.

摘要

目的

确定使用液体栓塞剂乙烯-乙烯醇(EVOH)共聚物对急性咯血患者进行支气管动脉栓塞术(BAE)的技术成功率和临床成功率。

材料与方法

回顾性分析34例行EVOH支气管动脉栓塞术的患者(25例男性;平均年龄58岁;范围13 - 78岁)。急性咯血的原因包括肺癌(44%)、肺转移瘤(12%)、支气管扩张症((21%)、动静脉畸形(5%)、肺结核(6%)、曲菌球(3%)、急性呼吸窘迫综合征(3%)、抗凝药物过量(3%)和瘢痕组织(3%)。对BAE的技术成功率和临床成功率进行回顾性评估。

结果

94%的患者栓塞术技术成功。4例患者(12%)需要额外的栓塞材料。即刻临床成功率为94%(34例中的32例);2例患者(6%)在介入治疗后咯血立即复发或无法止血。围介入期轻微并发症包括头痛(1例)、发热(1例)和急性肾衰竭(1例)。在随访期间(平均8.8个月),5例患者咯血复发(15%)。

结论

在急性咯血患者中使用EVOH共聚物进行BAE技术上成功且安全,临床效果良好,复发率低。

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