Haemoptysis due to chronic tuberculosis vs. bronchiectasis: comparison of long-term outcome of arterial embolisation. |
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Authors: | J-H Lee S-Y Kwon H-I Yoon C J Yoon K-W Lee S-G Kang C-T Lee |
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Affiliation: | Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Medical Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea. |
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Abstract: | OBJECTIVE: To evaluate the factors that influence the outcome of bronchial arterial embolisation (BAE) in chronic tuberculosis (TB). In cases of chronic TB, non-bronchial systemic arteries (NBSA) provide a significant source of massive or recurrent haemoptysis. DESIGN: Medical records and radiological findings of 30 consecutive TB patients who underwent BAE were retrospectively analysed and compared with those of 19 bronchiectasis patients. RESULTS: Chronic TB patients had higher numbers of total feeding vessels (4.40 +/- 3.85 vs. 1.79 +/- 1.51, P = 0.007) and NBSA (1.57 +/- 1.63 vs. 0.42 +/- 0.61, P = 0.005) than the bronchiectasis patients. The number of embolisations required for obliterating feeding vessels (3.87 +/- 2.48 vs. 1.95 +/- 1.47, P = 0.004), and the incidence of incomplete embolisation (30% vs. 5.3%, P = 0.033) were also higher in the TB patients. Moreover, recurrence after BAE was more frequent in the TB patients (17/30, 56.7% vs. 5/19, 26.3%, P = 0.037). Male sex, past history of haemoptysis and incomplete embolisation during BAE were associated with higher recurrence of haemoptysis in chronic TB patients. The existence of a fungus ball or significant pleural thickening (>/=10 mm) was not found to influence the recurrence rate of haemoptysis. CONCLUSION: The haemoptysis recurrence rate was higher in chronic TB than in bronchiectasis; this was found to be related to incomplete feeding vessel embolisation. |
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