Bronchial artery embolisation for massive haemoptysis: immediate and long-term outcomes-a retrospective study.
Author(s)
Type
Journal Article
Abstract
INTRODUCTION: Bronchial artery embolisation (BAE) is an established treatment method for massive haemoptysis. The aim of this study is to evaluate the impact of BAE on in-hospital outcomes and long-term survival in patients with massive haemoptysis. METHODS: Retrospective review of all cases of acute massive haemoptysis treated by BAE between April 2000 and April 2012 with at least a 5 year follow up of each patient. Targeted BAE was performed in cases with lateralising symptoms, bronchoscopic sites of bleeding or angiographic unilateral abnormal vasculature. In the absence of lateralising symptoms or signs, bilateral BAE was performed. RESULTS: 96 BAEs were performed in 68 patients. The majority (64 cases, 67%) underwent unilateral procedures. 83 (86.5%) procedures resulted in immediate/short term control of haemoptysis which lasted for longer than a month. The mean duration of haemoptysis free period after embolisation was 96 months. There were three major complications (cardio-pulmonary arrest, paraparesis and stroke). 38 (56%) patients were still alive at least 5 years following their BAE. Benign causes were associated with significantly longer haemoptysis free periods, mean survival 108 months compared to 32 months in patients with an underlying malignant cause (p = 0.005). An episode of haemoptysis within a month of the initial embolisation was associated reduced overall survival (p = 0.033). CONCLUSION: BAE is effective in controlling massive haemoptysis. Long-term survival depends on the underlying pulmonary pathology. Strategies are required to avoid incomplete initial embolisation, which is associated with ongoing haemoptysis and high mortality despite further BAE.
Date Issued
2020-06
Date Acceptance
2020-03-01
Citation
Pulmonary Therapy, 2020, 6 (1), pp.107-117
ISSN
2364-1746
Publisher
Springer
Start Page
107
End Page
117
Journal / Book Title
Pulmonary Therapy
Volume
6
Issue
1
Copyright Statement
© The Author(s) 2020. Open Access This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any non-commercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/32185642
PII: 10.1007/s41030-020-00112-x
Subjects
Bronchial arteries
Haemoptysis
Therapeutic embolisation
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2020-03-17