Treatment of Hemoptysis in Behçet Syndrome with Pulmonary and Bronchial Embolization

Lacombe, Pascal; Qanadli, Salah D.; Jondeau, Guillaume; Barré, Olivier; Mesurolle, Benoı̂t; Mouas, H.; Igual, Jeanine; Chagnon, S; Dubourg, Olivier; Bourdarias, Jean-Pierre

doi:10.1016/s1051-0443(97)70708-5

Cited by 25 publications

(19 citation statements)

References 10 publications

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“…Cure time was 6.4±5.5 (range: 2-24; median: 5) months (n=18). 14,25,34,38,46,47,54,56,59,61,63,65,73,81,91,95,113,116 In 11 cases PAA embolization materials were described, as follows: N-butyl cyanoacrylate (n=3, 27.3%), 34,41 Nester® Embolization Coils (n=3, 27.3%), 74,76 Amplatzer devices (n=3, 27.3%), 64,66,72 Ethylene Vinyl Alcohol Copolymer (n=1, 9.1%) 71 and Guglielmi detachable coils (n=1, 9.1%). 60 In patients with multiple PAAs, the number of embolization coils deployed in a single patient varied from 2, 74 through 6, 74 to 10.…”

Section: Resultsmentioning

confidence: 99%

“…29,68,114 Hematopoietic stem cell transplantation 86 and tumor necrosis factor-α plus infliximab 25 were indicated for patients refractory to conventional immunosuppressive therapy. Indications for interventional embolization included bilateral pulmonary artery involvement, 74 giant pulmonary artery pseudoaneurysm, 87 ruptured PAAs, 64 failed conservative treatment, 34 to avoid potential surgical complications 60 and patients' reluctance to undergo surgical operations. 72 Patients with rapidly expanding pulmonary artery (pseudo)aneurysms 24,26,107 or with recurrent PAA following successful percutaneous embolization 24 usually warranted surgical operations; while patients with uncontrolled massive hemoptysis with impending PAA rupture often required an emergency operation.…”

Section: Resultsmentioning

confidence: 99%

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Pulmonary artery aneurysms in Behçet disease

Yuan

2014

J. vasc. bras.

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Pulmonary artery aneurysms (PAAs) are the most common type of pulmonary involvement in Behçet' s disease. However, the relationships between clinical features and prognosis have not been sufficiently evaluated. This article describes the results of a comprehensive review, revealing that PAAs have a predilection for hemoptysis manifestations, increased dimensions, right lower lobar location, multiplicity and concurrent intramural thrombus formation. Surgical intervention was needed in one third of patients. Patients with massive hemoptysis and PAA rupture warranted emergency operations. Conservatively treated patients were prone to PAA progression; interventional embolization was associated with higher risks of recurrence and reintervention for PAAs; and surgically treated patients exhibited the highest mortality rates. In conclusion, PAAs in Behçet' s disease are characterized by a predilection for hemoptysis manifestations, right lower lobar location, multiplicity, and concurrent intramural thrombus formation. Both the condition itself and the surgical operations it warrants are linked with high mortality due to PAA hemorrhage.Keywords: hemoptysis; therapeutic embolization; vasculitis. ResumoOs aneurismas das artérias pulmonares (PAA) são as manifestações mais comuns dos pulmões na doença de Behçet. No entanto, as relações entre as características clínicas e o prognóstico ainda não foram devidamente explicadas. O objetivo do presente artigo foi fazer uma ampla revisão da literatura sobre esta questão. As fontes de dados contaram com uma ampla revisão bibliográfica dos anos de 1990 a 2013, sobre os seguintes temas: doença de Behçet, síndrome de HughesStovin, aneurisma de artéria pulmonar e pseudoaneurisma da artéria pulmonar. Os PAA evoluíram com predileção por hemoptise, aumento de dimensões, localização no lobo inferior direito, multiplicidade e formação de trombo intramural. A intervenção cirúrgica foi necessária em um terço dos pacientes. O tratamento cirúrgico emergencial foi indicado na vigência de ruptura do PAA e de hemoptise maciça. Os pacientes tratados conservadoramente evoluíram com propensão para a progressão do PAA. A embolização dos PAA foi associada a uma taxa maior de recidiva e de reintervenção. Houve diferença significativa entre os grupos quanto às taxas de mortalidade, tendo o grupo do tratamento cirúrgico apresentado a maior taxa. Dentre as variáveis citadas, a hemoptise, o envolvimento da artéria lobar e a ruptura do PAA foram fatores preditivos de maior risco de mortalidade. Houve diferenças significativas nas taxas de mortalidade entre os pacientes cirúrgicos e intervencionistas, e entre os três grupos de pacientes: cirúrgico, intervencionista e conservador. Os pacientes tiveram uma sobrevida global de 61,7% em um seguimento médio de 22,5 meses. Os PAA, na doença de Behçet, apresentaram as seguintes predileções: tendência a hemoptise, multiplicidade, localização no lobo inferior direito e presença de trombos intramurais. As rupturas e hemorragias dos PAA, aliadas ao necessário tr...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Pulmonary artery aneurysms in Behçet disease

Yuan

2014

J. vasc. bras.

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“…Initially, surgical resection was proposed to treat cases of massive hemoptysis due to ruptured aneurysms but the results have been discouraging (de Montpréville et al 1996;Lacombe et al 1997;Aroussi et al 2005). In some cases, the surgical treatment succeeded (Fernandez et al 2010;Takahoma et al 2009).…”

Section: Pulmonary Arterial Vasculitismentioning

confidence: 99%

“…Such intervention is also contraindicated in bilateral and multiple aneurysms. Endovascular embolization techniques have been used successfully to thrombose bleeding PAA (Mouas et al 1996;Lacombe et al 1997;Cantasdemir et al 2002;Hiller et al 2004;Pelage et al 2005;Uzun et al 2005;Peall and Jones 2009).…”

Section: Pulmonary Arterial Vasculitismentioning

confidence: 99%

“…The technique varies from one center to another. Most interventional radiologists have used coils, while in some selective cases by placement of a temporary occlusion balloon catheter (Lacombe et al 1997;Ghaye and Dondelinger 2001;Cantasdemir et al 2002;Pelage et al 2005;Hammad et al 2009). The aneurysms are embolized by insertion of several steel coils (Figs.…”

Section: Pulmonary Arterial Vasculitismentioning

confidence: 99%

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