scholarly journals Clinical outcomes of cystic fibrosis patients with hemoptysis treated with bronchial artery embolization

2021 ◽  
pp. e20200557
Author(s):  
Marília Amaral Peixoto da Silveira1,2 ◽  
Patrícia Amaral Peixoto da Silveira3 ◽  
Flávia Gabe Beltrami1,2 ◽  
Leandro Armani Scaffaro4 ◽  
Paulo de Tarso Roth Dalcin1,2
Keyword(s):  
Cystic Fibrosis ◽  
Chronic Infection ◽  
Retrospective Cohort ◽  
Bronchial Artery ◽  
Massive Hemoptysis ◽  
Recurrent Bleeding ◽  
Bronchial Artery Embolization ◽  
Artery Embolization ◽  
Period 2 ◽  
Number Of Patients

Objective: Massive hemoptysis is one of the most serious complications in patients with cystic fibrosis (CF). This study aimed to evaluate the hemoptysis-free period following bronchial and non-bronchial artery embolization (BAE/non-BAE) in CF patients and to investigate predictors of recurrent bleeding and mortality by any cause. Methods: This was a retrospective cohort study of CF patients = 16 years of age undergoing BAE/non-BAE for hemoptysis between 2000 and 2017. Results: We analyzed 39 hemoptysis episodes treated with BAE/non-BAE in 17 CF patients. Hemoptysis recurrence rate was 56.4%. Of the sample as a whole, 3 (17.6%) were hemoptysis-free during the study period, 2 (11.8%) underwent lung transplantation, and 3 (17.6%) died. The median hemoptysis-free period was 17 months. The median hemoptysis-free period was longer in patients with chronic infection with Pseudomonas aeruginosa (31 months; 95% CI: 0.00-68.5) than in those without that type of infection (4 months; 95% CI: 1.8-6.2; p = 0.017). However, this association was considered weak, and its clinical significance was uncertain due to the small number of patients without that infection. Conclusions: BAE appears to be effective in the treatment of hemoptysis in patients with CF.

scholarly journals Feasibility and outcomes of bronchial artery embolization in patients with non-massive hemoptysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jung Han Hwang ◽  
Jeong Ho Kim ◽  
Suyoung Park ◽  
Ki Hyun Lee ◽  
So Hyun Park
Keyword(s):  
Survival Rate ◽  
Bronchial Artery ◽  
Clinical Success ◽  
Massive Hemoptysis ◽  
Recurrent Bleeding ◽  
Recurrence Free Survival ◽  
Bronchial Artery Embolization ◽  
Artery Embolization ◽  
Free Survival

Abstract Purpose To evaluate the safety, efficacy, and long-term outcome of bronchial artery embolization (BAE) in the treatment of non-massive hemoptysis and the prognostic factors associated with recurrent bleeding. Materials and methods From March 2005 to September 2014, BAE was performed in 233 patients with non-massive hemoptysis. All patients had a history of persistent or recurrent hemoptysis despite conservative medical treatment. We assessed the technical and clinical success, recurrence, prognostic factors related to recurrent bleeding, recurrence-free survival rate, additional treatment, and major complications in all the patients. Results Technical success was achieved in 224 patients (96.1%), and clinical success was obtained in 219 (94.0%) of the 233 patients. In addition, 64 patients (27.5%) presented hemoptysis recurrence with median time of 197 days after embolization. Tuberculosis sequelae and presence of aberrant bronchial artery or non-bronchial systemic collaterals were significantly related to recurrent bleeding (p < 0.05). The use of Histoacryl-based embolic materials significantly reduced the recurrent bleeding rate (p < 0.05). Patient who had a tuberculosis sequelae showed a significantly lower recurrence-free survival rate (p = 0.013). Presence of aberrant bronchial artery or non-bronchial systemic collaterals showed a statistically significant correlation with recurrence-free survival rate (p = 0.021). No patients had major complications during follow-up. Conclusions BAE is a safe and effective treatment to manage non-massive hemoptysis. The procedure may offer a better long-term control of recurrent hemoptysis and quality of life than conservative therapy alone.

scholarly journals Recurrent massive hemoptysis in a patient with cystic fibrosis: balloon assisted Onyx embolization after bronchial artery coil recanalization

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Raghav R. Mattay ◽  
Richard Shlansky-Goldberg ◽  
Bryan A. Pukenas
Keyword(s):  
Cystic Fibrosis ◽  
Bronchial Artery ◽  
Balloon Catheter ◽  
Embolic Agent ◽  
Massive Hemoptysis ◽  
Bronchial Artery Embolization ◽  
Artery Embolization ◽  
Bronchial Arteries ◽  
Occlusion Balloon ◽  
Occlusion Balloon Catheter

Abstract Background Although not standard of care, Cystic Fibrosis patients with recurrent hemoptysis occasionally have coil embolization of bronchial arteries. In the event of recanalization of these arteries in this specific subset of patients, the presence of indwelling coils makes the prospect of conventional particle embolization more difficult, preventing both adequate catheterization of the coiled segment and reflux of the particles. Case presentation In this report, we describe a case of bronchial artery embolization of a complex Cystic Fibrosis patient with massive hemoptysis from recanalized coiled bronchial arteries utilizing a Scepter Balloon Catheter® (Microvention Terumo, USA) in administration of the liquid embolic agent Onyx® (Medtronic, USA). Conclusions The Scepter occlusion balloon catheter allowed for careful placement of the tip within the interstices of the pre-existing coils, allowing for Onyx injection directly into the coil mass without reflux, reconfirming the benefits of Onyx embolization in bronchial artery embolization and providing evidence that the Scepter occlusion balloon catheter should be added to the armamentarium of devices used in complex bronchial artery embolization for Cystic Fibrosis patients with massive hemoptysis.

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