Uflacker R, Kaemmerer A, Picon P D, Rizzon C F, Neves C M, Oliveira E S, Oliveira M E, Azevedo S N, Ossanai R
Radiology. 1985 Dec;157(3):637-44. doi: 10.1148/radiology.157.3.4059552.
Seventy-five patients with hemoptysis were treated with bronchial artery embolization (BAE). The procedure was performed with Hexabrix (sodium methylglucamine ioxaglate), Mikaelson catheters, and Gelfoam particles. Angiographic evaluation of the bronchial artery anatomy revealed ten different configurations, which are described. The embolization attempt failed in three cases (4%); eight additional patients (10.7%) were excluded from the series because of inadequate data. In the remaining 64 patients, 41 underwent BAE alone and 23 underwent either chemotherapy or surgery in addition to embolization. Immediate control of hemoptysis was achieved in 49 of 64 patients (76.6%). Long-term control of hemoptysis was achieved in 46 of the 56 patients included in the long-term follow-up (82.1%). Eight of the 64 patients were lost to follow-up, which ranged from one to 47 months (mean 24.8 months). Hemoptysis recurred in 12 of 56 patients (severe in 10, mild in 2) (21.4%). Twelve patients died (21.4%), five of them due to hemoptysis (8.9%). None of the patients who died of hemoptysis had responded to initial BAE. It is concluded that BAE is an effective treatment for immediate control of life-threatening hemoptysis, allowing long-term control of bleeding in the majority of patients.
75例咯血患者接受了支气管动脉栓塞术(BAE)治疗。该手术使用Hexabrix(碘克沙醇葡甲胺钠)、米凯尔森导管和明胶海绵颗粒进行。对支气管动脉解剖结构的血管造影评估显示出10种不同的形态,并对其进行了描述。3例(4%)栓塞尝试失败;另外8例患者(10.7%)因数据不充分被排除在该系列研究之外。在其余64例患者中,41例仅接受了BAE治疗,23例除栓塞外还接受了化疗或手术治疗。64例患者中有49例(76.6%)咯血得到即时控制。纳入长期随访的56例患者中有46例(82.1%)咯血得到长期控制。64例患者中有8例失访,随访时间为1至47个月(平均24.8个月)。56例患者中有12例咯血复发(10例严重,2例轻微)(21.4%)。12例患者死亡(21.4%),其中5例死于咯血(8.9%)。死于咯血的患者中无一例对初始BAE有反应。结论是,BAE是一种有效治疗危及生命咯血的方法,能使大多数患者长期控制出血。