Bronchial artery embolization for hemoptysis: A systematic review and meta-analysis

Zheng, Zhiyuan; Zhuang, Zhiquan; Yang, Mei; Luo, Jianjun; Wen, Zheng; Yan, Zhenlin; Wang, Xiaolin

doi:10.1016/j.jimed.2021.08.003

Cited by 10 publications

(9 citation statements)

References 38 publications

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“…However, follow-up and chest X- After an evaluation, recurrent hemoptysis persisted, although there was some improvement compared to before. Embolization can increase the level of direct bleeding control to over 70% 12 . The goal of embolization in cases of bleeding is to selectively lower arterial perfusion pressure and minimize extravasation of blood from bleeding vessels while maintaining adequate collateral blood flow to minimize ischemic damage to normal tissues.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Hemoptysis Post Re-Embolization in a 49 Year-Old Male with Post Tuberculosis Lung Disease (PTLD) and Bronchiectasis

Primaputri,

Pratiwi,

Aslam

2024

MRJ

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Introduction: Hemoptysis is a symptom of lung disease, could be caused by lung infections, structural disorders of the lung, malignancy or disorders from outside of the lung. One of the pulmonary intervention for hemoptysis is embolization with a success rate > 70%, but the recurrence rate reaches 10-55%. The prognosis is poor depending on the amount of bleeding (untreated cases can have a mortality risk of over 50%), etiology and presence of recurrences. Case Illustration: A 49-year-old Male came to the policlinic with recurrent hemoptysis for a year. Non-smoker. History of Lung Tuberculosis (TB), completed treatment 15 years ago. Imaging result showed widening of the right subcostal artery, right posterior intercostal artery, bronchiectasis, active lung tuberculosis and left pulmonary emphysema. First embolization was done during Anti-Tuberculosis Drug (ATD) treatment for 6 months. Symptom of hemoptysis reappeared, then second embolization and fiber optic bronchoscopy (FOB) was performed. From the evaluation, he was diagnosed with infected bronchiectasis and PTLD, therefore given antibiotic medications for 2 weeks. Discussion: Embolization had been done twice in this case, no significant result. Based on literature, recurrent hemoptysis can still occur with a percentage about 10-55% after embolization and in this case, it might be caused by previous lung structural disorder and lung infections (Lung TB and Infected bronchiectasis). Conclusion: Although embolization has a success rate of > 70% for hemoptysis treatment, recurrence can still occur and highly dependent on the cause itself and patient's previous lung condition. Keywords: Hemoptysis, Embolization, Bronchiectasis, FOB, Lung TB, PTLD, ATD

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Section: Discussionmentioning

confidence: 99%

Recurrent Hemoptysis Post Re-Embolization in a 49 Year-Old Male with Post Tuberculosis Lung Disease (PTLD) and Bronchiectasis

Primaputri,

Pratiwi,

Aslam

2024

MRJ

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“…In recent years, with the rapid development of interventional science, angiography and transcatheter arterial occlusion have been widely applied in the examination and treatment of bleeding patients. Among other benefits noted, the arterial occlusion for hemoptysis caused by various reasons has improved year by year (20)(21)(22), and these methods can provide effective palliative treatment for hemoptysis patients who cannot tolerate surgical treatment. In our study, 13 patients in the observation group in had hemoptysis symptoms of different degrees before surgery, and all patients were treated with regional systemic artery embolization before surgery to relieve hemoptysis symptoms.…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical effects between regional arterial embolization combined with surgery and simple surgery in the treatment of tuberculosis-destroyed lung—a retrospective comparative cohort study

Wang¹,

Jiang²,

Zhang³

et al. 2023

J Thorac Dis

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Background: The patients with tuberculosis-destroyed lungs often have heavy adhesion in the affected side of the pleural cavity and abundant collateral circulation, which bring about considerable challenges to surgical treatment. Some patients with tuberculosis-destroyed lungs will have hemoptysis symptoms. In clinical work, we found that patients with hemoptysis before surgery due to hemoptysis through regional artery occlusion treatment often have less bleeding during surgery, and it is relatively easy to stop bleeding during surgery, and the operation time is short. This study mainly used retrospective comparative cohort studies to explore the clinical efficacy of combined surgical treatment after regional systemic artery embolization pretreatment of tuberculosis-destroyed lung and provides a basis for further optimizing the surgical treatment of tuberculosis-destroyed lung.Methods: From June 2021 to September 2022, 28 patients with tuberculosis-destroyed lungs who underwent surgery in our department from the same medical group were selected. The patients were divided into 2 groups according to whether regional arterial embolization was introduced before surgery. In the observation group (n=13), before surgery, all patients received arterial embolization in the target area for hemoptysis, and surgery was performed 24-48 h after embolization. In the control group (n=15), direct surgical treatment was performed without embolization. The factors including operation time, intraoperative blood loss, and postoperative complication rates were compared between the 2 groups to assess the value of regional artery embolization combined with surgery in the treatment of tuberculosis-destroyed lung.Results: There was no significant difference between the 2 groups in general condition and disease condition, including age, duration of disease, location of lesion, and operation method (P>0.05). The operation time in the observation group was shorter than that in the observation group (P<0.05), the amount of intraoperative bleeding in the observation group was lower than that in the control group (P<0.05). The incidence of postoperative complications including pulmonary infection, anemia, and hypoproteinemia in the observation group was lower than that in the control group (P<0.05). Conclusions: Regional arterial embolism preconditioning combined with surgical operation may reduce the risk of conventional surgical treatment, shorten the operation time, and reduce postoperative complications.

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“…Các nghiên cứu trong những năm gần đây quan tâm đến khái niệm "thành công về mặt kỹ thuật" được định nghĩa là thuyên tắc hoàn toàn động mạch bệnh lý bao gồm ĐMPQ và ĐMHTKPQ. Nhìn chung thành công về mặt kỹ thuật trong khoảng 77 -99%, với tỷ lệ gộp là 99% theo nghiên cứu gộp của Zheng 7 . Tỉ lệ "thành công về mặt kỹ thuật" trong lần thực hiện đầu tiên ở nghiên cứu của chúng tôi là 97,5%, ở mức cao như các nghiên cứu gần đây trên thế giới.…”

Section: Hình 1: Giả Phình Mạch (Mũi Tên) Trong Vùng đôNg đặC Hoại Tử...unclassified

Vai Trò Can Thiệp Nội Mạch Trong Điều Trị Ho Ra Máu Ở Bệnh Nhân Lao Phổi

Nguyễn,

Huỳnh,

Lê

et al. 2024

VMJ

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Mục tiêu nghiên cứu: đánh giá tính hiệu quả và an toàn của can thiệp nội mạch điều trị ho ra máu ở bệnh nhân lao phổi; và đánh giá tỉ lệ tái phát sau can thiệp nội mạch. Phương pháp: Nghiên cứu đoàn hệ hồi cứu các trường hợp bệnh nhân ho ra máu do lao phổi được can thiệp nội mạch tại bệnh viện Chợ Rẫy từ năm 2020 đến tháng 2 năm 2023. Kết quả: Nghiên cứu thực hiện trên 81 bệnh nhân (tỉ lệ nam/nữ là 2,1/1); trung bình 54,9 tuổi. 13,6% bệnh nhân là lao phổi cấp tính và 86,4% là di chứng lao phổi. 227 động mạch bệnh lý được xác định; trung bình: 2,8 ± 1,7 động mạch trên một bệnh nhân. Dấu hiệu chính trên chụp mạch bao gồm: tăng sinh mạch máu ngoại biên (93,8%); phì đại gốc mạch, mạch máu giãn ngoằn ngoèo (86,4%); thông nối tuần hoàn phổi (39,5%); giả phình mạch (9,9%) và thoát mạch thuốc cản quang (1,2%). Thành công tức thời về mặt lâm sàng: 97,5%. Tỉ lệ tái phát trong vòng 6 tháng là 30,4%. U nấm phổi (HR = 3,77; p = 0,009) và thông nối tuần hoàn phổi (HR = 4,81,77; p = 0,009) là các yếu tố nguy cơ liên quan tái phát ho ra máu. Biến chứng nặng ghi nhận 1 trường hợp (1,2%) nhồi máu não sau thuyên tắc. Kết luận: Can thiệp nội mạch là hiệu quả và an toàn để điều trị các trường hợp ho ra máu do lao phổi, tuy nhiên tỉ lệ tái phát sau can thiệp còn cao.

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Bronchial artery embolization for hemoptysis: A systematic review and meta-analysis

Cited by 10 publications

References 38 publications

Recurrent Hemoptysis Post Re-Embolization in a 49 Year-Old Male with Post Tuberculosis Lung Disease (PTLD) and Bronchiectasis

Recurrent Hemoptysis Post Re-Embolization in a 49 Year-Old Male with Post Tuberculosis Lung Disease (PTLD) and Bronchiectasis

Comparison of clinical effects between regional arterial embolization combined with surgery and simple surgery in the treatment of tuberculosis-destroyed lung—a retrospective comparative cohort study

Vai Trò Can Thiệp Nội Mạch Trong Điều Trị Ho Ra Máu Ở Bệnh Nhân Lao Phổi

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