Department of Radiology, University Hospitals Leuven, Herestraat 49, Leuven B-3000, Belgium; Department of Imaging and Pathology, Katholieke Universiteit Leuven, Leuven, Belgium.
Department of Radiology, University Hospitals Leuven, Herestraat 49, Leuven B-3000, Belgium; Department of Imaging and Pathology, Katholieke Universiteit Leuven, Leuven, Belgium.
J Vasc Interv Radiol. 2018 Apr;29(4):502-509. doi: 10.1016/j.jvir.2017.11.015. Epub 2018 Feb 22.
To assess safety, efficacy, and long-term outcome of repeat bronchial artery embolization (BAE) for recurrent hemoptysis.
This was a retrospective study of patients referred for repeat BAE to manage recurrent hemoptysis after initial successful embolization. BAE was performed in 223 patients; 36 (16.1%) of these patients underwent 59 repeat BAE procedures because of recurring symptoms. The most frequent underlying lung diseases were bronchiectasis (n = 8; 22%), cystic fibrosis (n = 7; 19%), and idiopathic hemoptysis (n = 7; 19%).
Most patients (64%) underwent 2 embolization procedures owing to vessel recanalization (71%) as the most frequent pathophysiologic mechanism of recurrent hemoptysis. No serious adverse events requiring prolonged hospital stay were noted. Risk for relapse of hemoptysis was significantly lower for bronchiectasis compared with other chronic infections (P = .0022) and cystic fibrosis (P = .0004). Overall survival after 3-year and 5-year follow-up was 92% and 84%, respectively.
Repeat BAE for recurrent hemoptysis after initial successful BAE is safe and efficacious, especially in patients with bronchiectasis as the underlying lung disease.
评估支气管动脉栓塞术（BAE）治疗复发性咯血的安全性、疗效和长期结果。
本研究回顾性分析了因初始成功栓塞后复发性咯血而接受重复 BAE 治疗的患者。223 例患者接受了 BAE 治疗；其中 36 例（16.1%）患者因症状复发而接受了 59 次重复 BAE 治疗。最常见的潜在肺部疾病是支气管扩张症（n=8；22%）、囊性纤维化（n=7；19%）和特发性咯血（n=7；19%）。
大多数患者（64%）因血管再通（71%）而行 2 次栓塞治疗，这是复发性咯血最常见的病理生理机制。未发生需要长时间住院治疗的严重不良事件。与其他慢性感染（P=0.0022）和囊性纤维化（P=0.0004）相比，支气管扩张症患者咯血复发的风险明显较低。3 年和 5 年随访后的总体生存率分别为 92%和 84%。
在初始成功 BAE 治疗后，复发性咯血行重复 BAE 是安全有效的，特别是在支气管扩张症作为潜在肺部疾病的患者中。
