Bronchial Artery Embolization for Hemoptysis in Cystic Fibrosis Patients: A 17-Year Review |
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| Affiliation: | 1. Division of Interventional Radiology, Stanford Medicine, 300 Pasteur Drive, H3630, Stanford, CA 94305;2. Division of Pulmonary and Critical Care Medicine, Stanford Medicine, 300 Pasteur Drive, H3630, Stanford, CA 94305;1. Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, Illinois;2. Department of Surgery, Division of Surgical Oncology, University of Louisville, Louisville, Kentucky;3. Vascular and Interventional Professionals, Hinsdale, Illinois;4. Department of Radiology, Section of Interventional Radiology, Mount Sinai Hospital, New York, New York;5. GetWellNetwork, Inc, Menlo Park, California;6. (Formerly) HealthLoop, Inc, Mountain View, California;7. Division of Hospital Medicine, University of California San Francisco, San Francisco, California;1. Department of Radiology, University of Virginia, 1215 Lee Street, Charlottesville, VA 22908;2. Department of Medical Imaging and Surgery, University of Virginia, 1215 Lee Street, Charlottesville, VA 22908;1. Department of Pediatric Radiology, Diagnostic Imaging, McMaster Children’s Hospital, 1200 Main St. W., Hamilton, ON L8N 3Z5, Canada;2. Division of Image Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada;1. Department of Radiology, Hanyang University Guri Hospital, Guri, Republic of Korea;2. Department of Radiology, College of Medicine, Kangwon National University, Chuncheon, Republic of Korea;3. Department of Radiology, Hanyang University Hospital, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Sungdong-gu, Seoul 04763, Republic of Korea;4. Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Republic of Korea;1. Department of Interventional Radiology, The Reading Hospital and Medical Center, West Reading, Pennsylvania;2. Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas;3. Department of Cardiovascular and Interventional Radiology, Inova Alexandria Hospital, Alexandria, Virginia;4. Department of Radiology, Haga Teaching Hospital, Den Haag, The Netherlands;5. Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands;6. Department of Radiology, Cardiovascular Services, University of Melbourne, Royal Children’s Hospital, St Vincent’s Private Hospital, Fitzroy, Victoria, Australia |
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| Abstract: | PurposeTo review safety and efficacy of bronchial artery embolization (BAE) for treatment of hemoptysis in adult patients with cystic fibrosis (CF) and to report 30-day, 1-year, and 3-year outcomes.Materials and MethodsBetween January 2001 and April 2018, 242 patients with CF were evaluated for hemoptysis. Thirty-eight BAEs were performed in 28 patients with hemoptysis. Technical success was defined as freedom from repeat embolization and hemoptysis-related mortality. Clinical success was defined as freedom from repeat embolization and mortality from any cause. Technical and clinical success were examined at 30 days, 1 year, and 3 years after initial BAE. Mean patient age was 32 years, and median follow-up was 4.8 years (range, 10 mo to 16.7 y).ResultsTechnical and clinical success rates at 30 days were 89% (25/28) and 82% (23/28), respectively. Success rates at 1 year were 86% (24/28) and 79% (22/28), respectively, and at 3 years were 82% (23/28) and 75% (21/28), respectively. The 30-day overall complication rate was 7.9% (3/38) with 2.6% (1/38) major complication rate and 5.2% (2/38) minor complication rate. Overall 3-year mortality rate was 25% (7/28).ConclusionsBAE is safe and effective in patients with CF presenting with life-threatening hemoptysis. BAE results in high rates of long-term technical and clinical success in this patient population despite progressive chronic disease. Repeat embolization is necessary only in a minority of patients. |
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