Freidkin Lev, Zamaereh Ramzi, Izhakian Shimon, Rosengarten Dror, Pertzov Barak, Amor Shai M, Krolik Alex, Heching Moshe, Kramer Mordechai R
Pulmonary Division, Rabin Medical Center, Petah Tikva, Israel.
School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
J Thorac Dis. 2025 Apr 30;17(4):2265-2272. doi: 10.21037/jtd-24-1783. Epub 2025 Apr 21.
Hemoptysis is a potentially life-threatening condition attributable to various pulmonary diseases. Bronchoscopy plays an important role in hemoptysis management to localize and treat the source of bleeding. While deployment of endobronchial blockers to achieve hemostasis has been widely described, the repurpose of the Amplatzer Vascular Plug device (AVPD), designed for vascular embolization, for endobronchial bleeding has been rarely described. The aim of this study is to present our experience with AVPD for managing hemoptysis and assess its efficacy as a treatment option.
We conducted a retrospective analysis of patients admitted to our tertiary medical center with massive or sub-massive hemoptysis where an AVPD was deployed during bronchoscopy to achieve hemostasis. We collected demographic data, medical history, hemoptysis etiology, bronchoscopy procedures, hemostasis outcomes and follow-up.
Fifteen patients with a median age of 60 years (range, 24-86 years) with massive or sub-massive hemoptysis were treated with endobronchial deployment of an AVPD. Eleven patients (73%) suffered from massive hemoptysis. AVPD deployment successfully achieved concurrent hemostasis in 14 (93%) cases, with four patients requiring subsequent surgical or endovascular treatments to achieve definitive hemostasis. In 5 (33%) cases, the AVPD was subsequently removed after a median period of 23 days, with no recurrent hemoptysis. Three patients (20%) expired within a week of the bronchoscopy for causes unrelated to the AVPD deployment or hemoptysis.
Endobronchial deployment of AVPD is an effective management tool for hemoptysis either as a definitive treatment or as a bridge to surgical or endovascular treatment. To our knowledge, this is the first case series of AVPD use for hemoptysis management. Further research encompassing a larger patient population including comparison of results with standard of care treatment is required to further substantiate our results.
咯血是一种由多种肺部疾病引起的潜在危及生命的病症。支气管镜检查在咯血管理中发挥着重要作用，可用于定位和治疗出血源。虽然使用支气管内封堵器实现止血已被广泛报道，但专为血管栓塞设计的Amplatzer血管封堵装置（AVPD）用于支气管内出血的用途鲜有描述。本研究的目的是介绍我们使用AVPD治疗咯血的经验，并评估其作为一种治疗选择的疗效。
我们对入住我们三级医疗中心的大量或亚大量咯血患者进行了回顾性分析，这些患者在支气管镜检查期间使用AVPD实现止血。我们收集了人口统计学数据、病史、咯血病因、支气管镜检查程序、止血结果和随访情况。
15例年龄中位数为60岁（范围24 - 86岁）的大量或亚大量咯血患者接受了支气管内AVPD置入治疗。11例（73%）患者出现大量咯血。AVPD置入成功在14例（93%）病例中实现了即时止血，4例患者需要随后的手术或血管内治疗以实现最终止血。5例（33%）病例中，AVPD在中位时间23天后被取出，无咯血复发。3例（20%）患者在支气管镜检查后一周内死亡，原因与AVPD置入或咯血无关。
支气管内置入AVPD是咯血的一种有效管理工具，可作为确定性治疗或作为手术或血管内治疗的桥梁。据我们所知，这是首例使用AVPD治疗咯血的病例系列。需要进一步开展包括更大患者群体的研究，包括将结果与标准治疗进行比较，以进一步证实我们的结果。
