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Wei F, Yaowen C, Wenhui W. Embolization treatment of right pulmonary artery agenisis with patent ductus arteriosus causing pulmonary hypertension and hemoptysis: a case report and literature review. J Cardiothorac Surg 2024; 19:391. [PMID: 38926785 PMCID: PMC11209968 DOI: 10.1186/s13019-024-02883-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
As the pediatric patient with right pulmonary artery agenesis (PAA) matured, she progressively presented symptoms of pulmonary hypertension and hemoptysis. There is limited clinical literature on this condition, and currently, there is no consensus regarding its diagnosis and treatment. This article presents a case study of a 16-year-old female patient with right pulmonary artery hypoplasia, providing a comprehensive summary and analysis of her developmental progression, pathology, diagnosis, and treatment.
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Affiliation(s)
- Fan Wei
- Department of Interventional medicine, The First Clinical Medical College of Lanzhou University, the First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Chang Yaowen
- Department of Interventional medicine, The First Clinical Medical College of Lanzhou University, the First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China
| | - Wang Wenhui
- Department of Interventional medicine, The First Clinical Medical College of Lanzhou University, the First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China.
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Sheehan F, Graham A, Tait NP, Ind P, Alsafi A, Jackson JE. Bronchial artery embolization using small particles is safe and effective: a single center 12-year experience. Eur Radiol 2024:10.1007/s00330-024-10836-y. [PMID: 38861163 DOI: 10.1007/s00330-024-10836-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/21/2024] [Accepted: 05/04/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Bronchial artery embolization (BAE) using particles is an established treatment for hemoptysis. The use of polyvinyl alcohol (PVA) with a particle size of 300 µm or larger is thought to reduce the risk of non-target embolization but may result in more proximal vessel occlusion than is ideal, resulting in a high rate of early recurrent hemorrhage. OBJECTIVE This study evaluates the safety and efficacy of BAE using PVA particles with a size of less than 300 µm. METHODS All patients who underwent BAE between 2010 and 2022 at a tertiary center were included. Demographic data, etiology and volume of hemoptysis, technical and clinical success, procedure-related complications, and follow-up information were collected from patients' electronic records. 150-250 µm PVA particles were used to commence embolization in all patients with the subsequent use of larger-sized particles in some individuals. The Kaplan-Meier method was used to estimate recurrence and survival rates. RESULTS One hundred forty-four patients underwent 189 embolization procedures between 2010 and 2022 and were followed up for a median of 35 months [IQR 19-89]. 150 µm to 250 µm PVA particles were used as the sole embolic agent in 137 cases. Hemoptysis recurred within 30 days in 7%. The median time to repeat intervention was 144 days [IQR 42-441]. Seventeen out of 144 patients had a pulmonary artery branch pseudoaneurysm. The rate of major complications was 1% with no instances of stroke or spinal artery ischemia. Thirty-day mortality was 2% (4/189). CONCLUSION BAE using 150-250 µm PVA particles is safe and effective with few complications and low rates of early hemoptysis recurrence. CLINICAL RELEVANCE STATEMENT BAE using small particles is likely to improve outcomes, particularly the rate of early recurrence, in patients with hemoptysis, without an increase in procedural complications. KEY POINTS BAE is a safe and effective treatment for patients with hemoptysis. Using small PVA particles in BAE has few complications and low rates of early recurrence. Pulmonary artery pseudoaneurysms should be actively sought in those with hemoptysis undergoing BAE.
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Affiliation(s)
- Frances Sheehan
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK
| | - Alison Graham
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK
| | - N Paul Tait
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK
| | - Philip Ind
- Department of Respiratory Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Ali Alsafi
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK.
- Department of Surgery and Cancer, Imperial College London, London, UK.
| | - James E Jackson
- Imaging Department, Imperial College Healthcare NHS Trust, London, UK
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Xu HD, Yang L, Hu SB. Embosphere microspheres size for bronchial artery embolization in patients with hemoptysis caused by bronchiectasis: a retrospective comparative analysis of 500-750 versus 700-900 μm microspheres. BMC Pulm Med 2024; 24:203. [PMID: 38658883 PMCID: PMC11044458 DOI: 10.1186/s12890-024-03019-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 04/16/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Bronchial arterial embolization (BAE) has been accepted as an effective treatment for bronchiectasis-related hemoptysis. However, rare clinical trials compare different sizes of specific embolic agents. This study aims to evaluate whether different Embosphere microsphere sizes change the outcome of BAE. METHODS A retrospective review was conducted on consecutive patients with bronchiectatic hemoptysis who were scheduled to undergo BAE treatment during a period from January 2018 to December 2022. The patients received BAE using microspheres of different sizes: group A patients were treated with 500-750 μm microspheres, and group B patients were treated with 700-900 μm microspheres. The cost of embolic microspheres (Chinese Yuan, CNY), duration of hospitalization, complications, and hemoptysis-free survival were compared between patients in group A and those in group B. A Cox proportional hazards regression model was used to identify predictors of recurrent hemoptysis. RESULTS Median follow-up was 30.2 months (range, 20.3-56.5 months). The final analysis included a total of 112 patients (49-77 years of age; 45 men). The patients were divided into two groups: group A (N = 68), which received 500-750 μm Embosphere microspheres, and group B (N = 44), which received 700-900 μm Embosphere microspheres. Except for the cost of embolic microspheres(group A,5314.8 + 1301.5 CNY; group B, 3644.5 + 1192.3 CNY; p = 0.042), there were no statistically significant differences in duration of hospitalization (group A,7.2 + 1.4 days; group B, 8 + 2.4days; p = 0.550), hemoptysis-free survival (group A, 1-year, 2-year, 3-year, 85.9%, 75.8%, 62.9%; group B, 1-year, 2-year, 3-year, 88.4%, 81.2%,59.4%;P = 0.060), and complications(group A,26.5%; group B, 38.6%; p = 0.175) between the two groups. No major complications were observed. The multivariate analysis results revealed that the presence of cystic bronchiectasis (OR 1.61, 95% CI 1.12-2.83; P = 0.001) and systemic arterial-pulmonary shunts (SPSs) (OR 1.52, 95% CI 1.10-2.72; P = 0.028) were independent risk factors for recurrent bleeding. CONCLUSIONS For the treatment of BAE in patients with bronchiectasis-related hemoptysis, 500-750 μm diameter Embosphere microspheres have a similar efficacy and safety profile compared to 700-900 μm diameter Embosphere microspheres, especially for those without SPSs or cystic bronchiectasis. Furthermore, the utilization of large-sized (700-900 μm) Embosphere microspheres is associated with the reduced cost of an embolic agent.
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Affiliation(s)
- Hong-Dou Xu
- Department of Interventional Radiology, Gaochun Peoples Hospital Affiliated to Jiangsu University, 53 Maoshan Road, Gaochun District, Nanjing, 211302, Jiangsu, China
| | - Liang Yang
- Department of Interventional Radiology, Gaochun Peoples Hospital Affiliated to Jiangsu University, 53 Maoshan Road, Gaochun District, Nanjing, 211302, Jiangsu, China
| | - Shi-Bing Hu
- Department of Interventional Radiology, Gaochun Peoples Hospital Affiliated to Jiangsu University, 53 Maoshan Road, Gaochun District, Nanjing, 211302, Jiangsu, China.
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Sahasrabudhe TR, Mohan S, Pawal SK, Meshram SB. Glue ablation of Rasmussen's aneurysm in a case of epituberculosis. BMJ Case Rep 2023; 16:e253372. [PMID: 38011962 PMCID: PMC10685935 DOI: 10.1136/bcr-2022-253372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
A woman in her 40s presented with massive haemoptysis and breathlessness for 1 day. She had been diagnosed with pulmonary tuberculosis based on sputum CBNAAT (Cartridge Based Nucleic Acid Amplification Test) and was on antitubercular treatment for previous 2 weeks. Her chest X-ray showed right middle lobe lateral segment dense consolidation with bilateral nodular infiltrates. CT pulmonary angiography (CTPA) revealed a well-defined homogenously enhancing vascular lesion of size 10×11×13 mm in the right hilar region communicating with the descending branch of right pulmonary artery, suggesting a Rasmussen's aneurysm. It was in close proximity to the segmental bronchus that was almost completely occluded, suggesting epituberculosis. Transvenous pulmonary artery glue embolisation successfully achieved complete ablation of the aneurysm with preserved arterial flow. She has later completed 6 months of antitubercular treatment and is cured with no recurrence of haemoptysis. Her lung infiltrates have resolved with some lung scarring.
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Affiliation(s)
- Tushar Ramesh Sahasrabudhe
- Respiratory Medicine, Dr D Y Patil Medical College, Hospital and Research center, Dr D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Sona Mohan
- Respiratory Medicine, Dr D Y Patil Medical College, Hospital and Research center, Dr D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Sambhaji Kantrao Pawal
- Interventional Radiology, Dr D Y Patil Medical College, Hospital and Research Center, Dr D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Shailesh Bhanudas Meshram
- Respiratory Medicine, Dr D Y Patil Medical College, Hospital and Research center, Dr D Y Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
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Karlafti E, Tsavdaris D, Kotzakioulafi E, Kougias L, Tagarakis G, Kaiafa G, Netta S, Savopoulos C, Michalopoulos A, Paramythiotis D. Which Is the Best Way to Treat Massive Hemoptysis? A Systematic Review and Meta-Analysis of Observational Studies. J Pers Med 2023; 13:1649. [PMID: 38138876 PMCID: PMC10744930 DOI: 10.3390/jpm13121649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Hemoptysis is one of the most common symptoms of respiratory system diseases. Common causes include bronchiectasis, tumors, tuberculosis, aspergilloma, and cystic fibrosis. The severity of hemoptysis varies from mild to moderate to massive hemoptysis and can easily lead to hemodynamic instability and death from suffocation or shock. Nevertheless, the most threatening hemoptysis that is presented to the emergency department and requires hospitalization is the massive one. In these cases, today, the most common way to manage hemoptysis is bronchial artery embolization (BAE). METHODS A systematic literature search was conducted in PubMed and Scopus from January 2017 (with the aim of selecting the newest possible reports in the literature) until May 2023 for studies reporting massive hemoptysis. All studies that included technical and clinical success rates of hemoptysis management, as well as rebleeding and mortality rates, were included. A proportional meta-analysis was conducted using a random-effects model. RESULTS Of the 30 studies included in this systematic review, 26 used bronchial artery embolization as a means of treating hemoptysis, with very high levels of both technical and clinical success (greater than 73.7% and 84.2%, respectively). However, in cases where it was not possible to use bronchial artery embolization, alternative methods were used, such as dual-vessel intervention (80% technical success rate and 66.7% clinical success rate), customized endobronchial silicone blockers (92.3% technical success rate and 92.3% clinical success rate), antifibrinolytic agents (50% clinical success rate), and percutaneous transthoracic embolization (93.1% technical success rate and 88.9% clinical success rate), which all had high success rates apart from antifibrinolytic agents. Of the 2467 patients included in these studies, 341 experienced rebleeding during the follow-up period, while 354 other complications occurred, including chest discomfort, fever, dysphagia, and paresis. A total of 89 patients died after an episode of massive hemoptysis or during the follow-up period. The results of the meta-analysis showed a pooled technical success of bronchial artery embolization equal to 97.22% and a pooled clinical success equal to 92.46%. The pooled recurrence was calculated to be 21.46%, while the mortality was 3.5%. These results confirm the ability of bronchial artery embolization in the treatment of massive hemoptysis but also emphasize the high rate of recurrence following the intervention, as well as the risk of death. CONCLUSION In conclusion, massive hemoptysis can be treated with great clinical and technical success using bronchial artery embolization, reducing mortality. Mortality has now been reduced to a small percentage of cases.
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Affiliation(s)
- Eleni Karlafti
- Emergency Department, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
- 1st Propaedeutic Department of Internal Medicine, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.K.); (G.K.); (C.S.)
| | - Dimitrios Tsavdaris
- 1st Propaedeutic Surgery Department, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.T.); (S.N.); (A.M.); (D.P.)
| | - Evangelia Kotzakioulafi
- 1st Propaedeutic Department of Internal Medicine, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.K.); (G.K.); (C.S.)
| | - Leonidas Kougias
- Department of Radiology, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Georgios Tagarakis
- Department of Cardiothoracic Surgery, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Georgia Kaiafa
- 1st Propaedeutic Department of Internal Medicine, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.K.); (G.K.); (C.S.)
| | - Smaro Netta
- 1st Propaedeutic Surgery Department, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.T.); (S.N.); (A.M.); (D.P.)
| | - Christos Savopoulos
- 1st Propaedeutic Department of Internal Medicine, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (E.K.); (G.K.); (C.S.)
| | - Antonios Michalopoulos
- 1st Propaedeutic Surgery Department, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.T.); (S.N.); (A.M.); (D.P.)
| | - Daniel Paramythiotis
- 1st Propaedeutic Surgery Department, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (D.T.); (S.N.); (A.M.); (D.P.)
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Singhal R, K.B SB, Naranje P, Kazimi J, Garg PK, Chandra D, Popat BA, Shetty NS, Gorsi U, Vimala LR, Khera PS, Irodi A, Kulkarni S, Keshava SN, Bhalla AS. Society of Chest Imaging and Interventions Consensus Guidelines for the Interventional Radiology Management of Hemoptysis. Indian J Radiol Imaging 2023; 33:361-372. [PMID: 37362365 PMCID: PMC10289864 DOI: 10.1055/s-0043-1762552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
The recommendations from the Society of Chest Imaging and Interventions expert group comprehensively cover all the aspects of management of hemoptysis, highlighting the role of diagnostic and interventional radiology. The diversity existing in etiopathology, imaging findings, and management of hemoptysis has been addressed. The management algorithm recommends the options for effective treatment while minimizing the chances of recurrence, based on the best evidence available and opinion from the experts.
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Affiliation(s)
- Rajat Singhal
- Department of Interventional Radiology, Division of Clinical Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santhosh Babu K.B
- Department of Interventional Radiology, Division of Clinical Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Priyanka Naranje
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Junaid Kazimi
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Pawan K. Garg
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India
| | - Daksh Chandra
- Interventional Radiology Department, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Bhavesh A. Popat
- Department of Interventional Radiology, Hinduja Hospital, Mumbai, Maharashtra, India
- Department of Interventional Radiology, Breach Candy Hospital, Mumbai, Maharashtra, India
- Department of Interventional Radiology, Saifee Hospital, Mumbai, Maharashtra, India
| | - Nitin S. Shetty
- Interventional Radiology Department, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Ujjwal Gorsi
- Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Leena Robinson Vimala
- Department of Radiodiagnosis, Division of Clinical Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pushpinder S. Khera
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Jodhpur, Rajasthan, India
| | - Aparna Irodi
- Department of Radiodiagnosis, Division of Clinical Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Suyash Kulkarni
- Interventional Radiology Department, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Shyamkumar N. Keshava
- Department of Interventional Radiology, Division of Clinical Radiology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ashu S. Bhalla
- Department of Radio-Diagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
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Le Tat T, Carlier R, Zhang N, Bouchet A, Amar R, Zhou J, El Hajjam M. Endovascular Management of Life-Threatening Hemoptysis in Primary Lung Cancer: A Retrospective Study. Cardiovasc Intervent Radiol 2023:10.1007/s00270-023-03488-w. [PMID: 37311841 DOI: 10.1007/s00270-023-03488-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/29/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the efficacy and safety of endovascular treatment of hemoptysis caused by primary lung cancer. METHODS We conducted a single-center retrospective study (2005-2021), including patients who underwent thoracic embolization for life-threatening hemoptysis complication of lung cancer. Exclusion criteria were hemoptysis caused by a benign lung tumor or by a lung metastasis of a primary non-lung tumor. Depending on the origin of the bleeding, determined by CT-angiography, systemic arteries were treated with microspheres or coils, and pulmonary arteries with coils, plugs or covered stents. Outcomes were assessed from patients' medical records in April 2022. Primary endpoints were clinical success at one month and at one year. Secondary endpoints were incidence of complications, 1 year overall survival, and relative risk of recurrence of hemoptysis. Survival was compared with a log-rank test. RESULTS Sixty-two patients underwent 68 systemic artery embolizations and 14 pulmonary artery procedures. Clinical success defined as cessation of hemoptysis without any recurrence was 81% at one month and 74% at one year. Three major complications occurred: spinal cord ischemia, stroke, and acute pancreatitis. 5% of patient died from hemoptysis. One-year overall survival was 29% and was significantly higher in patients without hemoptysis recurrence when compared to patients with recurring hemoptysis (p = 0.021). In univariate analysis, recurrence of hemoptysis at one year was associated with massive hemoptysis (RR = 2.50; p = 0.044) and with tumor cavitation (RR = 2.51; p = 0.033). CONCLUSION Endovascular treatment for primary lung cancer-related hemoptysis is effective but not uneventful.
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Affiliation(s)
- Thomas Le Tat
- Imaging Department, Ambroise Paré Hospital (AP-HP), 9 Av. Charles de Gaulle, 92100, Boulogne-Billancourt, France.
| | - Robert Carlier
- Imaging Department, Ambroise Paré Hospital (AP-HP), 9 Av. Charles de Gaulle, 92100, Boulogne-Billancourt, France
| | - Norbert Zhang
- Imaging Department, Ambroise Paré Hospital (AP-HP), 9 Av. Charles de Gaulle, 92100, Boulogne-Billancourt, France
| | - Antoine Bouchet
- Imaging Department, Ambroise Paré Hospital (AP-HP), 9 Av. Charles de Gaulle, 92100, Boulogne-Billancourt, France
| | - Raphaël Amar
- Imaging Department, Ambroise Paré Hospital (AP-HP), 9 Av. Charles de Gaulle, 92100, Boulogne-Billancourt, France
| | - Jeffery Zhou
- Imaging Department, Ambroise Paré Hospital (AP-HP), 9 Av. Charles de Gaulle, 92100, Boulogne-Billancourt, France
| | - Mostafa El Hajjam
- Imaging Department, Ambroise Paré Hospital (AP-HP), 9 Av. Charles de Gaulle, 92100, Boulogne-Billancourt, France
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An J, Dong Y, Niu H. Application of the 5F JL4 Catheter in Bronchial Artery Embolization With the Opening in the Inferior Wall of the Aortic Arch. Vasc Endovascular Surg 2023; 57:379-385. [PMID: 36597616 DOI: 10.1177/15385744221149910] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND We investigated the efficacy and safety of bronchial artery embolization (BAE) using a 5F JL4 catheter in patients with hemoptysis and a bronchial artery opening in the inferior wall of the aortic arch. METHODS This was a single-center retrospective study. Seventeen patients underwent BAE using 5F JL4. We then evaluated technical success (TS), clinical success (CS), incidence of complications, and hemoptysis recurrence rate (RR). RESULTS The TS rate of microcatheter superselective catheterization and CS rate after surgery were 100%, and the incidence of severe complications and postoperative RR were 17.6%. CONCLUSIONS Bronchial artery embolization for hemoptysis with a BA opening in the inferior wall of the aortic arch using the 5F JL4 catheter could be a safe method. The short- and medium-term results were excellent.
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Affiliation(s)
- Jianli An
- Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, PR China
| | - Yanchao Dong
- Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, PR China
| | - Hongtao Niu
- Department of Interventional Treatment, Qinhuangdao Municipal No. 1 Hospital, Qinhuangdao, PR China
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Kettenbach J, Ittrich H, Gaubert JY, Gebauer B, Vos JA. CIRSE Standards of Practice on Bronchial Artery Embolisation. Cardiovasc Intervent Radiol 2022; 45:721-732. [PMID: 35396612 PMCID: PMC9117352 DOI: 10.1007/s00270-022-03127-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 01/24/2022] [Indexed: 01/21/2023]
Abstract
This CIRSE Standards of Practice document is aimed at interventional radiologists and provides best practices for performing bronchial artery embolisation to effectively treat haemoptysis. It has been developed by an expert writing group established by the CIRSE Standards of Practice Committee.
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Affiliation(s)
- Joachim Kettenbach
- Landesklinikum Wiener Neustadt, Institute of Diagnostics, Interventional Radiology and Nuclear Medicine, Wiener Neustadt, Austria.
| | - Harald Ittrich
- Department of Diagnostic and Interventional Radiology, Schoen Clinic Hamburg Eilbek, Hamburg, Germany
| | - Jean Yves Gaubert
- Department of Radiology, Timone University Hospital, Marseille, France.,Laboratory of Experimental Interventional Imaging, Aix-Marseille University, Marseille, France
| | - Bernhard Gebauer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Albert Vos
- Department of Interventional Radiology, St Antonius Hospital, Nieuwegein, Utrecht, The Netherlands
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Carey C, Jefferson A, Butterfield S, Ismail A, Barry P, Brennan A, Green H. A case of malignant stroke requiring hemicraniectomy following bronchial artery embolisation. Respir Med Case Rep 2022; 39:101730. [PMID: 36046101 PMCID: PMC9421389 DOI: 10.1016/j.rmcr.2022.101730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/05/2022] [Accepted: 08/15/2022] [Indexed: 11/01/2022] Open
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Dariushnia SR, Redstone EA, Heran MKS, Cramer HR, Ganguli S, Gomes AS, Hogan MJ, Himes EA, Patel S, Schiro BJ, Lewis CA. Society of Interventional Radiology Quality Improvement Standards for Percutaneous Transcatheter Embolization. J Vasc Interv Radiol 2021; 32:476.e1-476.e33. [PMID: 33640083 DOI: 10.1016/j.jvir.2020.10.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 01/14/2023] Open
Affiliation(s)
- Sean R Dariushnia
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Emory University School of Medicine, Grady Memorial Hospital, 80 Jesse Hill Dr, SE, Atlanta, GA, 30303.
| | - Ellen A Redstone
- Department of Interventional Radiology, St. Luke's University Health Network, 801 Ostrum St., Bethlehem, PA, 18015
| | - Manraj K S Heran
- Pediatric Interventional Radiology, Diagnostic & Therapeutic Neuroradiology, British Columbia's Children's Hospital, Vancouver General Hospital, University of British Columbia, 899 West 12th Avenue, Vancouver, BC, Canada
| | - Harry R Cramer
- Section of Interventional Radiology, Coastal Vascular and Interventional, PLLC, 3155 Hyde Park Place, Pensacola, FL, 32503
| | - Suvranu Ganguli
- Department of Radiology, Division of Interventional Radiology, Boston Medical Center, Boston University School of Medicine, 820 Harrison Avenue, FGH 4th Floor, Boston, MA, 02118
| | - Antoinette S Gomes
- Department of Radiological Sciences, Ronald Reagan UCLA Medical Center, 757 Westwood Plz Ste 2125, Los Angeles, CA, 90095-8358
| | - Mark J Hogan
- Department of Radiology, Section of Vascular and Interventional Radiology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205
| | - Elizabeth A Himes
- Society of Interventional Radiology, 3975 Fair Ridge Drive, Suite 400 North, Fairfax, VA, 22033
| | - Sheena Patel
- Society of Interventional Radiology, 3975 Fair Ridge Drive, Suite 400 North, Fairfax, VA, 22033
| | - Brian J Schiro
- Department of Vascular & Interventional Radiology, Miami Cardiac & Vascular Institute, 8900 N. Kendall Drive, Miami, FL, 33156, United States
| | - Curtis A Lewis
- Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Emory University School of Medicine, Grady Memorial Hospital, 80 Jesse Hill Dr, SE, Atlanta, GA, 30303
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Yang H, Yin J, Tang X, Li G, Li H, Zhao S. Clinical significance of interventional therapeutic bronchoscopy combined with bronchial arterial embolization in the treatment of hypervascular primary airway tumors in children. Pediatr Investig 2021; 5:130-135. [PMID: 34179710 PMCID: PMC8212720 DOI: 10.1002/ped4.12256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Pediatric hypervascular primary airway tumors are progressive, fatal lesions with a low incidence, and the disease is often more serious than that in adults. OBJECTIVE To evaluate the clinical efficacy and safety of interventional therapeutic bronchoscopy combined with conservative treatment and bronchial arterial embolization in children with primary airway tumors. METHODS We retrospectively analyzed the clinical data of four pediatric patients with hypervascular primary airway tumor between 2017 and 2019 at Beijing Children's Hospital. RESULTS Two patients were low-grade bronchial mucoepidermoid carcinoma, one patient was pleomorphic adenoma, and one was bronchial leiomyoma. Interventional therapeutic bronchoscopy combined with bronchial arterial embolization was used for treatment (all four patients received general anesthesia). The tumors were safely resected in all patients via interventional bronchoscopy. There were no severe complications related to the procedures. All patients were followed up for 5-12 months, and one low-grade bronchial mucoepidermoid carcinoma recurred. INTERPRETATION Interventional therapeutic bronchoscopy combined with bronchial arterial embolization appears to be a safe and efficient therapeutic method associated with less trauma and fewer complications, including no serious adverse events, in children with hypervascular primary airway tumors without bronchus wall infiltration.
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Affiliation(s)
- Haiming Yang
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Jie Yin
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Xiaolei Tang
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Gan Li
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Huimin Li
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Shunying Zhao
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
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Ishikawa H, Ohbe H, Omachi N, Morita K, Yasunaga H. Spinal Cord Infarction after Bronchial Artery Embolization for Hemoptysis: A Nationwide Observational Study in Japan. Radiology 2021; 298:673-679. [PMID: 33464182 DOI: 10.1148/radiol.2021202500] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background The most serious complication of bronchial artery embolization (BAE) for hemoptysis is spinal cord infarction. However, because it is rare, previous reports from single institutions have been insufficient to determine the actual prevalence of spinal cord infarction after BAE. Purpose To investigate the actual prevalence of spinal cord infarction as a complication of BAE using a nationally representative inpatient database. Materials and Methods This retrospective study was performed using data from the Japanese Diagnosis Procedure Combination database between July 2010 and March 2018. The authors identified patients who were diagnosed with hemoptysis and underwent BAE during hospitalization. The overall prevalence of spinal cord infarction after BAE was determined. The authors also compared the prevalence of spinal cord infarction using the Fisher exact test according to the embolic agent used for BAE: coils, gelatin sponge (GS) particles, and N-butyl-2-cyanoacrylate (NBCA). Results During the study period, 8563 patients (mean age ± standard deviation, 68 years ± 13; 5103 men) met the inclusion criteria. Among these 8563 patients, 1577 (18%), 6561 (77%), and 425 (5%) underwent BAE with coils, GS particles, and NBCA, respectively. The overall prevalence of spinal cord infarction as a complication of BAE was 0.19% (16 of 8563 patients). The prevalence of spinal cord infarction after BAE with coils, GS particles, and NBCA was 0.06% (one of 1577 patients), 0.18% (12 of 6561 patients), and 0.71% (three of 425 patients), respectively (P = .04). Conclusion With use of a nationwide real-world inpatient database, the results of this study demonstrated that the actual prevalence of spinal cord infarction as a complication of bronchial artery embolization (BAE) for hemoptysis was 0.19%. Patients who underwent BAE with coils had a lower prevalence of spinal cord infarction than patients who underwent BAE with gelatin sponge particles or N-butyl-2-cyanoacrylate. © RSNA, 2021.
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Affiliation(s)
- Hideo Ishikawa
- From the Hemoptysis and Pulmonary-Circulation Center, Eishinkai Kishiwada Rehabilitation Hospital, Kishiwada, Japan (H.I., N.O.); Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan (H.O., H.Y.); and Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (K.M.)
| | - Hiroyuki Ohbe
- From the Hemoptysis and Pulmonary-Circulation Center, Eishinkai Kishiwada Rehabilitation Hospital, Kishiwada, Japan (H.I., N.O.); Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan (H.O., H.Y.); and Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (K.M.)
| | - Naoki Omachi
- From the Hemoptysis and Pulmonary-Circulation Center, Eishinkai Kishiwada Rehabilitation Hospital, Kishiwada, Japan (H.I., N.O.); Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan (H.O., H.Y.); and Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (K.M.)
| | - Kojiro Morita
- From the Hemoptysis and Pulmonary-Circulation Center, Eishinkai Kishiwada Rehabilitation Hospital, Kishiwada, Japan (H.I., N.O.); Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan (H.O., H.Y.); and Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (K.M.)
| | - Hideo Yasunaga
- From the Hemoptysis and Pulmonary-Circulation Center, Eishinkai Kishiwada Rehabilitation Hospital, Kishiwada, Japan (H.I., N.O.); Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan (H.O., H.Y.); and Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan (K.M.)
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