急诊经导管支气管动脉栓塞术治疗支气管动脉-肺动脉瘘大咯血

目的探讨急诊经导管支气管动脉栓塞(BAE)治疗支气管动脉-肺动脉瘘大咯血的疗效。方法回顾性分析17例支气管动脉-肺动脉瘘大咯血患者动脉造影表现及急诊BAE的疗效。经急诊动脉造影明确出血部位后,采用聚乙烯醇(PVA)颗粒和明胶海绵条对出血动脉行BAE;术后评价疗效、并发症及咯血复发情况。结果 17例中共发现29支病变支气管动脉,成功予以栓塞。BAE术后16例24h内完全停止咯血,1例于术后2天完全停止咯血。5例于BAE后接受外科手术,切除原发病灶。BAE后未发生严重并发症,随访2年,咯血均无复发。结论急诊BAE治疗支气管动脉-肺动脉瘘大咯血安全、有效。

Emergent transcatheter bronchial arterial embolization in treatment of massive hemoptysis due to bronchial artery to pulmonary artery fistula

Objective To explore the curative effect of emergency transcatheter bronchial arterial embolization (BAE) on massive hemoptysis due to bronchial artery to pulmonary artery fistula. Methods The angiographic manifestations of massive hemoptysis in 17 cases due to bronchial artery to pulmonary artery fistula and curative effect of emergency BAE were retrospectively analyzed. Emergency angiography was performed to locate the bleeding artery, and then embolization was done using polyvinyl alcohol (PVA) particles and gelfoam strips. The curative effect and complications of BAE, as well as recurrence of bleeding were observed. Results In 17 cases, totally 29 bronchial arteries were located and embolized successfully. Hemoptysis stopped within 24 h after embolotherapy in 16 cases and 2 days later in 1 case. Five patients received surgical resection of primary lesions for radical cure after embolotherapy. There was no severe complication after embolotherapy. During 2-year follow-up, no rebleeding occurred. Conclusion Emergency BAE is safe and effective in treatment of massive hemoptysis due to bronchial artery to pulmonary artery fistula.