Mild-to-moderate hemoptysis: a diagnostic and clinical challenge

Microspheres present comparable efficacy and safety profiles compared with polyvinyl alcohol for bronchial artery embolization treatment in hemoptysis patients

“…In our study, 6-month (PVA vs. microspheres: 9.7% vs. 7.8%) and 1-year (PVA vs. microspheres: 9.7% vs. 8.9%) hemoptysis recurrence rates were similar between BAE using microspheres and BAE using PVA. The incidences of hemoptysis recurrence in our study were a little reduced compared with the data in previous studies, which reported that the hemoptysis-recurrence rate after BAE was estimated to be 10–29% [ 7 , 26 ]. The possible explanations might include (1) the relatively short follow-up in our study, (2) the exclusion of the patients with lung cancer, which was correlated with a great high likelihood of bleeding recurrence [ 29 , 30 ].…”

“…In addition, there was no difference of clinical success rate (96.8 vs. 100.0%) between microspheres and PVA groups, which suggested that microspheres presented similar immediate effect on controlling hemoptysis as PVA. The possible reasons might include that (1) The short-term good efficacy of BAE using PVA or microspheres in our study might be attributed to the CTBA evaluation prior to BAE as the regular protocol, which increased the accuracy of identification in the bleeding sources and underlying cause of hemorrhage [ 3 , 4 ]; (2) Furthermore, the majority of patients presented with mild-to-moderate hemoptysis, thereby decreasing the risk of failure to cannulate the bronchial artery or to facilitate a stable catheter position, which led to technical success rate of both 100% as well as similar clinical success between two groups [ 5 , 26 ]; (3) In addition, considering that microspheres and PVA were made of the same embolic material and of the same size, these two embolic agents therefore displayed similar technical and clinical success rate [ 14 , 27 ]. Of note, we found that offending vessels of left bronchial artery rather than right bronchial artery (vs. bilateral bronchial artery) was also an independent predictive factor for increased hemoptysis recurrence risk or mortality risk, which might be explained by that different anatomical structure.…”

“…Meanwhile, considering the more favorable cost of microspheres compared with PVA, the evidence suggested that microsphere might be an alternative option to PVA in BAE treatment. However, the present study still existed some limitations including (1) the sample size was relatively small in our study, which might lead to less statistical validation, more patients from multiple centers were needed for validation; (2) Longer follow-up was needed to observe the adverse events in hemoptysis patients underwent BAE; (3) The majority of patients included were with mild-to-moderate hemoptysis, therefore, more studies were necessary for extending our results in the treatment of massive hemoptysis [ 5 , 26 ]; (4) As this present study was an observational study, the patients enrolled in our study were not randomized into two groups, which might contribute to selection bias and confounding factors in present study.…”

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

“…In the past week, the symptoms worsened, with frequent coughing, and each episode of coughing was associated with approximately a quarter of a glass of fresh blood. Hemoptysis is defined as the expectoration of sputum mixed with blood originating from the lower respiratory tract, typically from the pulmonary bronchial arteries and lung parenchyma [1][2][3] .…”

Use of an innovative and non-invasive device for virologic sampling of cough aerosols in patients with community and hospital acquired pneumonia: a pilot study

“…BAL allows to collect specimens directly from the lungs and is considered an important tool in the etiological diagnosis of pneumonia. Despite the fact that flexible bronchoscopy is a safe and usually well tolerated procedure [8], due to its invasive nature, it is still not routinely performed in every patient or in every centre. Furthermore, even with this technique the sample risks to be contaminated by pathogens from the upper respiratory tract [9][10][11].…”