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Yan HT, Lu GD, Liu J, Liu S, Shi HB, Zhou CG, Zu QQ. Does the presence of systemic artery-pulmonary circulation shunt during bronchial arterial embolization increase the recurrence of noncancer-related hemoptysis? A retrospective cohort study. Respir Res 2023; 24:119. [PMID: 37131263 PMCID: PMC10152774 DOI: 10.1186/s12931-023-02427-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 04/19/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND The presence of systemic artery-pulmonary circulation shunt (SPS) during the bronchial arterial embolization (BAE) procedure, has been inferred to be a potential risk factor for recurrence. The aim of this study is to reveal the impact of SPS on the recurrence of noncancer-related hemoptysis after BAE. METHODS In this study, 134 patients with SPS (SPS-present group) and 192 patients without SPS (SPS-absent group) who underwent BAE for noncancer-related hemoptysis from January 2015 to December 2020 were compared. Four different Cox proportional hazards regression models were used to clarify the impact of SPSs on hemoptysis recurrence after BAE. RESULTS During the median follow-up time of 39.8 months, recurrence occurred in 75 (23.0%) patients, including 51 (38.1%) in the SPS-present group and 24 (12.5%) in the SPS-absent group. The 1-month, 1-year, 2-year, 3-year and 5-year hemoptysis-free survival rates in the SPS-present and SPS-absent groups were 91.8%, 79.7%, 70.6%, 62.3%, and 52.6% and 97.9%, 94.7%, 89.0%, 87.1%, and 82.3%, respectively (P < 0.001). The adjusted hazard ratios of SPSs in the four models were 3.37 [95% confidence intervals (CI), 2.07-5.47, P < 0.001 in model 1], 1.96 (95% CI, 1.11-3.49, P = 0.021 in model 2), 2.29 (95% CI, 1.34-3.92, P = 0.002 in model 3), and 2.39 (95% CI, 1.44-3.97, P = 0.001 in model 4). CONCLUSIONS The presence of SPS during BAE increases the recurrence probability of noncancer-related hemoptysis after BAE.
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Affiliation(s)
- Hai-Tao Yan
- Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Guang-Dong Lu
- Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Jin Liu
- Department of Clinical Medicine Research Institution, The First Affiliated Hospital with Nanjing Medical University, Nanjing, 210029, China
| | - Sheng Liu
- Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China
| | - Hai-Bin Shi
- Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China.
| | - Chun-Gao Zhou
- Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China.
| | - Qing-Quan Zu
- Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210029, China.
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Zhang CJ, Jiang FM, Zuo ZJ, Li SS, Zhao YA, Li PJ, Ye DF, Zhang LL, Tong LH, Chen SL, Li HM, Luo FM, Wang Y. Clinical characteristics and postoperative outcomes of systemic artery-to-pulmonary vessel fistula in hemoptysis patients. Eur Radiol 2022; 32:4304-4313. [PMID: 35029731 DOI: 10.1007/s00330-021-08484-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/12/2021] [Accepted: 11/26/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To investigate the clinical characteristics and outcomes on the success of bronchial arterial embolization (BAE) in patients with and without systemic artery-to-pulmonary vessel fistula (SA-PF) and to evaluate the feasibility of CTA in the assessment of SA-PF. METHODS We retrospectively enrolled 420 consecutive patients that underwent BAE for hemoptysis control in our hospital from September 2011 to May 2019. The clinical characteristics, preprocedural CTA findings, BAE procedural findings, and follow-up outcomes were collected. Patients were divided into two groups according to DSA findings: patients with SA-PF and those without. RESULTS A total of 184 (43.7%) patients presented with SA-PF. Pneumonia was less likely to be the concomitant condition in patients with SA-PF (p < 0.001). The mean number of culprit arteries per patient was significantly higher in patients with SA-PF compared to that in patients without SA-PF (p = 0.017). The SA-PF patients saw a greater probability of recurrence (HR: 2.782, 95% CI: 1.617-4.784, p < 0.001). SA-pulmonary venous fistula (SA-PVF) favored lower hemoptysis recurrence rate (HR: 0.199, 95%CI: 0.052-0.765, p = 0.019). SA-pulmonary artery fistula (SA-PAF) can be detected by optimized CTA protocol with a detection rate of 65.3% (49/75). CONCLUSIONS The presence of SA-PF is an independent risk factor predicting early recurrence of hemoptysis after BAE. SA-PVF seems to be a protective factor for longer hemoptysis control compared to SA-PAF. Optimized preprocedural CTA is a reliable examination to identify SA-PAF. KEY POINTS • The appearance of SA-PF is associated with a greater probability of early recurrent hemoptysis after bronchial artery embolization. • The presence of SA-PVF seems to be a protective factor for longer hemoptysis control after BAE compared to SA-PAF. • Optimized CTA protocol seems to be a promising auxiliary examination to detect SA-PAF.
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Affiliation(s)
- Chu-Jie Zhang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan Province, #37 Guo Xue Xiang, Chengdu, 610041, China
| | - Fa-Ming Jiang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan Province, #37 Guo Xue Xiang, Chengdu, 610041, China.,Center of Interventional Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Ze-Jin Zuo
- Institutional Review Board, West China Hospital, Sichuan University, Chengdu, China
| | - Shan-Shan Li
- Department of Intensive Care Unit, Karamay Municipal People's Hospital, Karamay, China
| | - Yue-An Zhao
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan Province, #37 Guo Xue Xiang, Chengdu, 610041, China
| | - Pei-Jun Li
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan Province, #37 Guo Xue Xiang, Chengdu, 610041, China
| | - Dong-Fan Ye
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan Province, #37 Guo Xue Xiang, Chengdu, 610041, China
| | - Lan-Lan Zhang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan Province, #37 Guo Xue Xiang, Chengdu, 610041, China
| | - Li-Hong Tong
- Department of Respiratory and Critical Care Medicine, Fourth Affiliated Hospital, Xinjiang Medical University, Urumqi, China
| | - Song-Lin Chen
- Department of Respiratory and Critical Care Medicine, Pangang Group General Hospital, Panzhihua, China
| | - Hai-Ming Li
- Department of Intensive Care Unit, Karamay Municipal People's Hospital, Karamay, China
| | - Feng-Ming Luo
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan Province, #37 Guo Xue Xiang, Chengdu, 610041, China.
| | - Ye Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Sichuan Province, #37 Guo Xue Xiang, Chengdu, 610041, China. .,Center of Interventional Radiology, West China Hospital, Sichuan University, Chengdu, China. .,Department of Intensive Care Unit, Karamay Municipal People's Hospital, Karamay, China.
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Zhu H, Lv F, Xu M, Wen S, Zheng Y, Zhang H. Case Report: Hemoptysis Caused by Pulmonary Tuberculosis Complicated With Bronchial Artery-Pulmonary Artery Fistula in Children. Front Pediatr 2021; 9:587342. [PMID: 33643968 PMCID: PMC7904673 DOI: 10.3389/fped.2021.587342] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 01/12/2021] [Indexed: 11/13/2022] Open
Abstract
Bronchial artery-pulmonary artery fistula secondary to pulmonary tuberculosis is an important cause of hemoptysis in adults, but it's relatively rare in children. Bronchial artery-pulmonary artery fistulas are mostly congenital in children and may have no clinical manifestations in the early stage. Congenital bronchial artery-pulmonary fistula with pulmonary tuberculosis can lead to hemoptysis. From 2016 to 2020, two children with pulmonary tuberculosis complicated with bronchial artery and pulmonary artery fistula were admitted and treated in our hospital. We reminded pediatricians to pay attention to a variety of etiology combined with the possibility of children's hemoptysis.
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Affiliation(s)
- Huihui Zhu
- Department of Pediatric Pulmonology, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fangfang Lv
- Department of Pediatric Pulmonology, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Ming Xu
- Department of Pediatric Pulmonology, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Shunhang Wen
- Department of Pediatric Pulmonology, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yangming Zheng
- Department of Pediatric Pulmonology, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Hailin Zhang
- Department of Pediatric Pulmonology, The Second Affiliated Hospital & Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
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