Prognosis and Predictors of Rebleeding After Bronchial Artery Embolization in Patients with Active or Inactive Pulmonary Tuberculosis

Kim, Seo Woo; Ryu, Yon Ju; Lee, Jin Hwa; Chang, Jung Hyun; Shim, Sung Shine; Kim, Yookyung

doi:10.1007/s00408-015-9728-4

Cited by 21 publications

(24 citation statements)

References 19 publications

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“…None of the patients suffered from major complications such as spinal cord injury. CT and angiographic findings are concordant with Kim et al including ground-glass opacity (72 %) and consolidation (61 %) as the most-specific findings for pulmonary bleeding in CT, and neo-vascularization (85 %) and vessel hypertrophy (45 %) as typical angiographic findings [10]. Active bleeding in angiographic images occurred in only 16 % of cases and should not be used for decision-making for BAE procedure.…”

supporting

confidence: 74%

Bronchial Artery Embolization in Hemoptysis: 10-Year Survival and Recurrence-Free Survival in Benign and Malignant Etiologies – A Retrospective Study

Syha

Benz

Hetzel

et al. 2016

Fortschr Röntgenstr

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Purpose: The aim of the study was to evaluate safety, effectiveness, recurrence rate and 10-year survival after bronchial artery embolization (BAE) in benign and malignant etiologies. Methods: The retrospective study includes 100?BAE procedures in 88 patients. Underlying disease was classified as benign (n?=?67) and malignant (n?=?21) etiologies. Immediate bleeding control and procedure safety were evaluated in all patients. In 51?(58?%) patients, follow-up data with a median follow-up time of 1015 days (range, 494 to 3727 days) were acquired to assess overall survival, time-to-recurrence of bleeding and recurrence-free survival, using Kaplan-Maier estimates to compare differences between both subgroups. Results: Immediate bleeding control was achieved after 96/100 procedures (96?%), with a?minor complication rate of 5.0?%. No major complications occurred. The overall survival was 74?%?after 1 year and 59?% after 5 years and 10?years. There was a significant difference in survival between the malignant and benign groups (p?

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supporting

confidence: 74%

Bronchial Artery Embolization in Hemoptysis: 10-Year Survival and Recurrence-Free Survival in Benign and Malignant Etiologies – A Retrospective Study

Syha

Benz

Hetzel

et al. 2016

Fortschr Röntgenstr

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“…[22,27,29] In the present study, the recurrence rate in patients with CPA was 55%, which is approximately two times higher than that of TB patients. [23,27–29] In addition, the majority of patients with recurrence of hemoptysis required repeat BAE. Therefore, additional treatments after a successful BAE are recommended to ensure the long-term success of the embolization in CPA patients.…”

Section: Discussionmentioning

confidence: 66%

“…[26] Numerous studies have demonstrated the effectiveness and success of BAE, especially in TB patients. [23,27–29] However, the recurrence of hemoptysis following successful BAE remains common and is associated with aspergilloma. [22,27,29] In the present study, the recurrence rate in patients with CPA was 55%, which is approximately two times higher than that of TB patients.…”

Section: Discussionmentioning

confidence: 99%

“…[23,27–29] However, the recurrence of hemoptysis following successful BAE remains common and is associated with aspergilloma. [22,27,29] In the present study, the recurrence rate in patients with CPA was 55%, which is approximately two times higher than that of TB patients. [23,27–29] In addition, the majority of patients with recurrence of hemoptysis required repeat BAE.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Bronchial Artery Embolization for Life-Threatening Hemoptysis in Patients with Chronic Pulmonary Aspergillosis

et al. 2016

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BackgroundBronchial artery embolization (BAE) is an important treatment option for short-term control of hemoptysis in patients with simple aspergilloma (SA). However, there are no data on the outcomes of BAE in patients with chronic pulmonary aspergillosis (CPA). In this study, the clinical characteristics and outcomes of BAE were investigated and compared in patients with CPA and SA.MethodsWe retrospectively analyzed the clinical data of 64 patients (55 [86%] with CPA and 9 [14%] with SA) who underwent BAE for life-threatening hemoptysis. The clinical characteristics and outcomes of BAE in CPA patients were compared to those of patients with SA.ResultsThe most common angiographic abnormality was hypervascularity (n = 60, 94%), followed by contrast extravasation (n = 50, 78%) and systemic-pulmonary shunt (n = 48, 75%), with similar incidence rates in both groups. Immediate success was achieved in 41 (64%) BAE procedures, but it was incomplete in 23 (36%) cases due to difficulty with the approach and/or overuse of contrast medium. Clinical failure of BAE was observed in only one (2%) patient. Complications following BAE were observed in four (6%) patients. Recurrence of hemoptysis was seen in a total of 33 patients (52%) within a median of 2.0 (0.3–10.0) months, and repeat BAE was performed in 25 (76%) of these cases. In comparing the outcomes of patients with CPA and SA, there were no differences in the rates of success of initial BAE, incomplete embolization, or clinical failure in the two groups. However, recurrence of hemoptysis tended to be higher in patients with CPA (55%) than in those with SA (33%). In addition, antifungal medications following BAE were more commonly prescribed in the CPA group (56%) compared to the SA group (0%).ConclusionsBAE was a safe and effective procedure for the management of life-threatening hemoptysis in patients with CPA. However, recurrence of hemoptysis was common, especially in patients with CPA. Therefore, definitive treatment for CPA following successful BAE should be considered to ensure the long-term success of the embolization in these patients.

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“…Lee et al, 2007) that patients with pulmonary TB history have a signi cantly higher number of total culprit arteries and culprit NBSAs than patients without pulmonary TB history [44]. According to prior studies, hemoptysis recurrence after BAE tended to be higher in patients with TB (chronic or active/reactivated TB) [37,41,44,45]. These outcomes are contrary to the current study, which has reported that pulmonary TB history was not related to re-bleeding.…”

Section: Discussionmentioning

confidence: 99%

Value of multidetector computed tomography angiography before bronchial artery embolization in hemoptysis management and early recurrence prediction: a prospective study

Le¹,

Phạm

et al. 2020

Preprint

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Background: Multidetector computed tomography (MDCT) angiography is an useful examination to detect the source of the bleeding in patients with hemoptysis. The aim of the study was to prospectively evaluate the role and clinical efficacy of MDCT angiography before bronchial artery embolization (BAE) for the management of hemoptysis, and to investigate the predictors of early recurrence.Methods: It is a double-center study which included 57 hemoptysis patients undergoing MDCT angiography prior to BAE from August 2019 to July 2020. A prospective analysis of culprit arteries detected by MDCT angiography allowed an evaluation of the role of this technique. A follow-up was done to assess the efficacy of BAE with preprocedural MDCT angiography and to explore the risk factors of early recurrent hemoptysis.Results: The accuracy of MDCT angiography in the identification of culprit arteries was as high as 97.5%. The average number of total culprit arteries per patient was 2.75 1.73. Among which, the average numbers of culprit ectopic bronchial arteries (BAs) and non-bronchial systemic arteries (NBSAs) per patient were 0.21 0.41 and 1.04 1.57, respectively. The immediate clinical success rate, total hemoptysis recurrence rate, and early hemoptysis recurrence rate of BAE following MDCT angiography were 94.7%, 18.5%, 16.7%, respectively. Aspergilloma (HR = 6.63, 95% CI: 1.31-33.60, p = 0.022) was associated with an increase in the risk of early recurrence.Conclusions: MDCT angiography should be performed before BAE for the management of hemoptysis. Aspergilloma was an independent predictor for early recurrence.

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Prognosis and Predictors of Rebleeding After Bronchial Artery Embolization in Patients with Active or Inactive Pulmonary Tuberculosis

Abstract: The risk of rebleeding after BAE in active or inactive PTB was high, particularly in patients with tuberculous-destroyed lung, chronic liver disease, the use of anticoagulant agents and/or antiplatelet agents, elevated pre-BAE CRP, and the existence of fungal ball.

Cited by 21 publications

References 19 publications

Bronchial Artery Embolization in Hemoptysis: 10-Year Survival and Recurrence-Free Survival in Benign and Malignant Etiologies – A Retrospective Study

Bronchial Artery Embolization in Hemoptysis: 10-Year Survival and Recurrence-Free Survival in Benign and Malignant Etiologies – A Retrospective Study

Outcomes of Bronchial Artery Embolization for Life-Threatening Hemoptysis in Patients with Chronic Pulmonary Aspergillosis

Value of multidetector computed tomography angiography before bronchial artery embolization in hemoptysis management and early recurrence prediction: a prospective study

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