Bronchial Artery Embolization for Hemoptysis Due to Benign Diseases: Immediate and Long-Term Results |
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Authors: | Akira Kato Sho Kudo Koichi Matsumoto Tetsuhiro Fukahori Toshihisa Shimizu Akira Uchino Shinichiro Hayashi |
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Institution: | (1) Department of Radiology, Saga Medical School, Nabeshima-5-1-1, Saga, 849, Japan, JP;(2) Department of Internal Medicine, Saga Medical School, Nabeshima-5-1-1, Saga, 849, Japan, JP |
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Abstract: | Purpose: To clarify the immediate effect and long-term results of bronchial artery embolization (BAE) for hemoptysis due to benign
diseases and the factors influencing the outcomes.
Methods: One hundred and one patients (aged 34–89 years) received bronchial artery embolization with polyvinyl alcohol particles and
gelatin sponge for massive or continuing moderate hemoptysis caused by benign pulmonary diseases and resistant to medical
treatment.
Results: After BAE, bleeding stopped in 94 patients (94%). The immediate effect was unfavorable in cases where feeder vessels were
overlooked or the embolization of the intercostal arteries was insufficient. Long-term cumulative hemoptysis nonrecurrence
rates after the initial embolization were 77.7% for 1 year and 62.5% for 5 years. In bronchitis (n = 9) and active tuberculosis (n = 4) groups, an excellent (100%) 5-year cumulative nonrecurrence rate was obtained. The rate was lower in groups with pneumonia/abscess/pyothorax
(n = 8) or with pulmonary aspergillosis (n = 9) (53.3%, 1-year cumulative nonrecurrence). There were higher incidences of early recurrence among patients with massive hemorrhage
or more marked vascularity and systemic artery–pulmonary artery shunt in angiography: however, these trends were not statistically
significant
Conclusions: BAE can yield long-term benefit in patients with hemoptysis due to benign diseases. Technical problems in the procedure had
an impact on the short-term effect. The degree of hemorrhage or the severity of angiographical findings were not significant
factors affecting the outcome. The most significant factor affecting long-term results was whether the inflammation caused
by the underlying disease was medically well controlled. |
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Keywords: | : Bronchial artery— Therapeutic embolization— Benign pulmonary diseases |
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