From the Hemoptysis and Pulmonary-Circulation Center, Eishinkai Kishiwada Rehabilitation Hospital, Kishiwada, Japan (H.I., N.O.); Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan (H.O., H.Y.); and Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (K.M.).
Radiology. 2021 Mar;298(3):673-679. doi: 10.1148/radiol.2021202500. Epub 2021 Jan 19.
Background The most serious complication of bronchial artery embolization (BAE) for hemoptysis is spinal cord infarction. However, because it is rare, previous reports from single institutions have been insufficient to determine the actual prevalence of spinal cord infarction after BAE. Purpose To investigate the actual prevalence of spinal cord infarction as a complication of BAE using a nationally representative inpatient database. Materials and Methods This retrospective study was performed using data from the Japanese Diagnosis Procedure Combination database between July 2010 and March 2018. The authors identified patients who were diagnosed with hemoptysis and underwent BAE during hospitalization. The overall prevalence of spinal cord infarction after BAE was determined. The authors also compared the prevalence of spinal cord infarction using the Fisher exact test according to the embolic agent used for BAE: coils, gelatin sponge (GS) particles, and -butyl-2-cyanoacrylate (NBCA). Results During the study period, 8563 patients (mean age ± standard deviation, 68 years ± 13; 5103 men) met the inclusion criteria. Among these 8563 patients, 1577 (18%), 6561 (77%), and 425 (5%) underwent BAE with coils, GS particles, and NBCA, respectively. The overall prevalence of spinal cord infarction as a complication of BAE was 0.19% (16 of 8563 patients). The prevalence of spinal cord infarction after BAE with coils, GS particles, and NBCA was 0.06% (one of 1577 patients), 0.18% (12 of 6561 patients), and 0.71% (three of 425 patients), respectively ( = .04). Conclusion With use of a nationwide real-world inpatient database, the results of this study demonstrated that the actual prevalence of spinal cord infarction as a complication of bronchial artery embolization (BAE) for hemoptysis was 0.19%. Patients who underwent BAE with coils had a lower prevalence of spinal cord infarction than patients who underwent BAE with gelatin sponge particles or -butyl-2-cyanoacrylate. © RSNA, 2021.
支气管动脉栓塞（BAE）治疗咯血最严重的并发症是脊髓梗死。然而，由于其罕见，以往来自单一机构的报告不足以确定 BAE 后脊髓梗死的实际发生率。目的：使用全国代表性的住院患者数据库研究 BAE 后脊髓梗死作为并发症的实际发生率。材料与方法：本回顾性研究使用了 2010 年 7 月至 2018 年 3 月期间日本诊断程序组合数据库的数据。作者确定了在住院期间诊断为咯血并接受 BAE 治疗的患者。确定了 BAE 后脊髓梗死的总体发生率。作者还根据用于 BAE 的栓塞剂（线圈、明胶海绵颗粒和丁基-2-氰基丙烯酸酯）使用 Fisher 精确检验比较了脊髓梗死的发生率。结果：在研究期间，8563 例患者（平均年龄 ± 标准差，68 岁 ± 13；5103 例男性）符合纳入标准。在这 8563 例患者中，分别有 1577 例（18%）、6561 例（77%）和 425 例（5%）接受了线圈、明胶海绵颗粒和 NBCA 的 BAE。BAE 作为并发症导致脊髓梗死的总体发生率为 0.19%（8563 例患者中有 16 例）。接受线圈、明胶海绵颗粒和 NBCA 的 BAE 后发生脊髓梗死的发生率分别为 0.06%（1577 例患者中有 1 例）、0.18%（6561 例患者中有 12 例）和 0.71%（425 例患者中有 3 例）（ =.04）。结论：使用全国真实世界住院患者数据库，本研究结果表明，咯血行 BAE 治疗后脊髓梗死作为并发症的实际发生率为 0.19%。接受线圈 BAE 的患者脊髓梗死发生率低于接受明胶海绵颗粒或 NBCA 行 BAE 的患者。© RSNA，2021.
