Kucukay Fahrettin, Topcuoglu Osman Melih, Alpar Ayhan, Altay Çetin Murat, Kucukay Murat Bulent, Ozbulbul Nilgun Isiksalan
Department of Interventional Radiology, Faculty of Medicine, Osmangazi University, Buyukdere mah. Meşelik kampusu, 22480, Eskisehir, Turkey.
Department of Interventional Radiology, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Cardiovasc Intervent Radiol. 2018 Feb;41(2):225-230. doi: 10.1007/s00270-017-1818-7. Epub 2017 Oct 24.
To investigate the safety, efficacy and long-term results of bronchial artery embolization with microsphere particles (Embosphere Microspheres, BioSphere Medical, Rockland, MA) 700-900 µm in size for massive hemoptysis.
One hundred and seventy-four patients (94 female, 80 male; mean age 39.4 ± 5.7) who had bronchial artery embolization for massive hemoptysis between January 2010 and October 2015 were incorporated in the study. Patients had hemoptysis with a mean volume of 525 ± 150 mL (median 500 mL, range 300-1200 mL) over a 24-h period. Underlying pathologies included bronchial artery hypertrophy due to bronchiectasis (56.3% [98/174]), lung cancer (29.9% [52/174]), tuberculosis (10.3% [18/174]) and the rest remained idiopathic (3.4% [6/174]). Mean bronchial artery diameter before the intervention was 3.8 ± 1.5 mm (median 4 mm, range 3.1-7.5 mm). Median follow-up period was 56 months (range 10-82 months). Primary objectives were the technical and clinical success.
Technical success was 100%. Clinical success for preventing massive hemoptysis was 91.9% (160/174). There was no procedure-related mortality or morbidities. Minor complications such as chest pain were observed in nine patients (5.0%). Recurrent hemoptysis (8.1%) was observed within 6 months in 14 patients, ten of whom were treated with a second embolization session and the remaining four with a total of three embolization sessions.
Bronchial artery embolization for massive hemoptysis with Embosphere particles 700-900 µm in size is a safe and effective method with high technical and clinical success rates. Long-term results are excellent.
探讨使用粒径为700 - 900微米的微球颗粒(Embosphere微球,生物球医疗公司,马萨诸塞州罗克兰)进行支气管动脉栓塞术治疗大量咯血的安全性、有效性及长期效果。
纳入2010年1月至2015年10月期间因大量咯血接受支气管动脉栓塞术的174例患者(94例女性,80例男性;平均年龄39.4±5.7岁)。患者24小时内咯血平均量为525±150毫升(中位数500毫升,范围300 - 1200毫升)。基础疾病包括支气管扩张导致的支气管动脉肥大(56.3% [98/174])、肺癌(29.9% [52/174])、肺结核(10.3% [18/174]),其余为特发性(3.4% [6/174])。干预前支气管动脉平均直径为3.8±1.5毫米(中位数4毫米,范围3.1 - 7.5毫米)。中位随访期为56个月(范围10 - 82个月)。主要目标是技术成功和临床成功。
技术成功率为100%。预防大量咯血的临床成功率为91.9%(160/174)。无手术相关死亡或并发症。9例患者(5.0%)出现胸痛等轻微并发症。14例患者在6个月内出现复发性咯血(8.1%),其中10例接受了第二次栓塞治疗,其余4例共接受了三次栓塞治疗。
使用粒径为700 - 900微米的Embosphere颗粒进行支气管动脉栓塞术治疗大量咯血是一种安全有效的方法,技术成功率和临床成功率高。长期效果良好。