Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization

Lee, Myoung Kyu; Kim, Sang-Ha; Yong, Suk Joong; Shin, Kye Chul; Kim, Hyun Sik; Yu, Tae Sun; Choi, Eun Hee; Lee, Won Yeon

doi:10.1111/crj.12104

Cited by 29 publications

(33 citation statements)

References 31 publications

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“…The median time from the 1st ssBACE to recurrent haemoptysis was 218 (57-452) days, and there were significant differences among underlying diseases (p = 0.020): the shortest time was 7 (5-9) days for patients with cryptogenic haemoptysis, and the longest time was 354 (165-534) days for patients with NTM pulmonary infection. The number of HRAs was 5 (3)(4)(5)(6)(7)(8) and 50% of patients showed exacerbation of underlying diseases at 2nd series ssBACE. The procedural success rate of 2nd series ssBACE was 97.7%, and no major and one minor complication of slight asymptomatic mediastinal haematoma due to wire perforation of an internal thoracic artery which did not need additional management were reported.…”

Section: Resultsmentioning

confidence: 96%

“…As previously reported, we defined haemoptysis and recurrent haemoptysis as airway bleeding with an estimated volume of greater than 20 cm 3 . In this study, ssBACE was indicated for patients with severe impairments to daily quality of life regardless of the amount of haemoptysis [16].…”

Section: Study Patients and Data Collectionmentioning

confidence: 99%

“…Haemoptysis affects patients with a wide variety of respiratory diseases, such as bronchiectasis, non-tuberculous mycobacterium (NTM) pulmonary infection and pulmonary aspergillosis [1][2][3][4][5][6]. As a result of the significant negative impact of massive haemoptysis on a patient's quality of life and risk of mortality, an interventional radiological approach known as bronchial artery embolisation (BAE) has been introduced and evaluated extensively [7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Mechanisms of recurrent haemoptysis after super-selective bronchial artery coil embolisation: a single-centre retrospective observational study

et al. 2018

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Objectives In recognition of the significant impairment caused by haemoptysis on a patient's quality of life, bronchial artery embolisation has been introduced worldwide as one of the first-line treatment options. Since little evidence is available on the mechanisms of recurrent haemoptysis after super-selective bronchial artery coil embolisation (ssBACE), the purpose of the present study is to evaluate these. Methods We retrospectively evaluated the mechanisms of recurrent haemoptysis using both enhanced computed tomography and cineangiography following ssBACE by reviewing 299 haemoptysis-related arteries (HRAs) in 57 consecutive patients who underwent 2nd series ssBACE for the management of recurrent haemoptysis between April 2010 and December 2015.Results Median age of patients was 69 (interquartile range 64-74) years, and 43.9% were men. This study revealed that (1) recanalisation was the most common mechanism (45.2%) followed by development of new HRA (38.5%), bridging collaterals (14.7%) and conventional collaterals (1.7%); (2) these trends could be modified in several situations such as with antiplatelet or anticoagulant medications; (3) relatively large-diameter HRAs were more likely to recanalise compared with small-diameter HRAs and (4) recurrent haemoptysis could be managed by 2nd series ssBACE with a procedural success rate of 97.7% without any major complications. Conclusions Recanalisation was the most common mechanism of recurrent haemoptysis after ssBACE. Our results provide interventionists with indispensable insights. Key Points • Recanalisation was the most common mechanism of recurrent haemoptysis after super-selective bronchial artery coil embolisation, followed by development of new haemoptysis-related arteries • These trends could be modified in several situations such as with antiplatelet or anticoagulant medications • Recurrent haemoptysis could be managed by 2nd series super-selective bronchial artery coil embolisation with a procedural success rate of 97.7% without any major complications.

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Section: Resultsmentioning

confidence: 96%

Section: Study Patients and Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mechanisms of recurrent haemoptysis after super-selective bronchial artery coil embolisation: a single-centre retrospective observational study

et al. 2018

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“…In our study, eight (24%) patients experienced recurrence after BAE during the median follow-up time of 15 months (IQR, 4-25.5 months). The recurrence rate after BAE ranged from 10% to 55.3% [2,11,15], and recurrent hemoptysis was reported to be associated with various factors including pulmonary aspergillosis [1,2,11], diabetes mellitus [13], hypertension [6], and systemic-pulmonary artery shunts on angiography [17,18].…”

Section: Discussionmentioning

confidence: 99%

“…Hemoptysis is a potentially life-threatening emergency situation requiring immediate diagnosis and therapy [1][2][3]. Based on the patient's condition, the potential treatments include conservative treatment, bronchoscopic intervention, bronchial artery embolization (BAE), and surgery [4][5][6]. Since BAE was first introduced in the early 1970s [7], it has played an important role in emergent palliative hemostasis of massive hemoptysis [4,8].…”

Section: Introductionmentioning

confidence: 99%

Clinical Features, Outcomes, and Predictors of Recurrence in Patients Treated with Bronchial Arterial Embolization Using a Gelatin Sponge to Control Hemoptysis

Wada

Furuya

Ike

et al. 2019

Interventional Radiology

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Objective: The clinical features and outcomes of bronchial arterial embolization (BAE) for hemoptysis were investigated, and we aimed to identify the factors associated with recurrent hemoptysis after BAE. Patients and Methods: Thirty-three consecutive patients treated with BAE for hemoptysis between July 2011 and June 2018 in a single medical center were retrospectively analyzed. Sex, age, body mass index, smoking history, comorbidity, laboratory data, etiology, angiographic findings, number and variety of embolized vessels, adverse events, and outcomes were evaluated. Results: The median age at the time of first BAE was 71 years (interquartile range [IQR], 59.5-86.5 years). The most common etiologies were cryptogenic hemoptysis (n=6), non-tuberculosis mycobacteriosis (n=6), pulmonary aspergillosis (n=5), bronchiectasis (n=5), and others (n=11). The common angiographic findings were neo-vascularization (n=31) and hypertrophied vessels (n=19). Eight patients (24%) experienced recurrence after BAE during the median follow-up time of 15 months (IQR, 4-25.5 months), and recurrence occurred in two patients (6%) within 1 month and in one patient (3%) after 3 years. The recurrence-free time after BAE was significantly shorter in patients with !20 pack-years smoking history (p=0.0218) and patients using anticoagulants or antiplatelet agents (p=0.0032). No moderate to severe adverse events related to BAE were encountered. Conclusion: BAE is a safe and effective treatment to control hemoptysis. However, recurrence occurred in 24% of our patient series. A smoking history of !20 pack-years and the use of anticoagulants or antiplatelet agents may be associated with a higher rate of recurrent hemoptysis following BAE.

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The impact of bronchial artery embolisation on the quality of life of patients with haemoptysis: a prospective observational study

et al. 2021

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Objectives Patients with haemoptysis often experience daily physical and mental impairment. Bronchial artery embolisation is among the first-line treatment options used worldwide; however, no evidence exists regarding the health-related quality of life (HRQoL) after bronchial artery embolisation. Therefore, this study aimed to evaluate the effects of bronchial artery embolisation on the HRQoL of patients with haemoptysis. Methods We prospectively enrolled 61 consecutive patients who visited our hospital from July 2017 to August 2018 and received bronchial artery embolisation for haemoptysis. The primary outcome was the HRQoL evaluated using the Short Form Health Survey, which contains physical and mental components, before and after bronchial artery embolisation. The secondary outcomes were procedural success, complications, and recurrence-free survival rate at 6 months. Results The mean age of the patients was 69 years (range, 31–87 years). The procedural success rate was 98%. No major complications occurred. The recurrence-free survival rate estimated using the Kaplan-Meier analysis at 6 months after bronchial artery embolisation was 91.8% (95% confidence interval, 91.1–92.5%). Compared with the pre-treatment scores, the physical and mental scores were significantly improved at 6 months after bronchial artery embolisation (p < 0.05). Conclusion Bronchial artery embolisation improved the HRQoL of patients with haemoptysis. Key Points • Bronchial artery embolisation improved the HRQoL of patients with haemoptysis. • Vessel dilation on computed tomography and systemic artery-pulmonary artery direct shunting on angiography were the most common abnormalities. • The recurrence-free survival rate estimated using the Kaplan-Meier analysis at 6 months after bronchial artery embolisation was 91.8%.

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Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization

Abstract: Moderate hemoptysis has shown similar prognosis of recurrent hemoptysis and mortality to massive hemoptysis. Therefore, the more aggressive FB and BAE should be considered in moderate hemoptysis.

Cited by 29 publications

References 31 publications

Mechanisms of recurrent haemoptysis after super-selective bronchial artery coil embolisation: a single-centre retrospective observational study

Mechanisms of recurrent haemoptysis after super-selective bronchial artery coil embolisation: a single-centre retrospective observational study

Clinical Features, Outcomes, and Predictors of Recurrence in Patients Treated with Bronchial Arterial Embolization Using a Gelatin Sponge to Control Hemoptysis

The impact of bronchial artery embolisation on the quality of life of patients with haemoptysis: a prospective observational study

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