CVIR endovascular · 2025
Efficacy of bronchial artery embolization in hemoptysis: longitudinal studyon survival and recurrence.
СтатьяНазвание и аннотация: Перевод в очереди
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Keshmiri Mohammad Sadegh, Astani Bahamin, Hosseini-Baharanchi Fatemeh Sadat, Sharif-Kashani Babak, Ahmadinia Mahdi, Mohammadi Sheida, Ranjbar Sepideh, Saliminejad Leila, Shafaghi Shadi
Аннотация
BACKGROUND AND OBJECTIVES: Managing hemoptysis can be challenging due to recurrences after different treatment methods. This study aimed to assess the efficacy and long-term outcomes of bronchial artery embolization (BAE) in controlling hemoptysis and improving patient survival.
METHODS: In this prospective cohort study, patients with hemoptysis undergoing BAE between August 2017 and August 2022 were enrolled and prospectively followed. Clinical characteristics, underlying etiologies, complications, and post-procedural recurrences were prospectively recorded during a 1- to 4-year follow-up period. The survival for each factor was graphed in subgroups by the Kaplan-Meier (KM) curve and presented the estimation of the hazard ratio (HR) with 95% confidence interval (CI) from the univariate Cox proportional hazard (PH) model.
RESULTS: A total of 297 patients (32% female, 58% with massive hemoptysis) were included. The mean survival time (MST) for all-cause mortality was 35.9 months (95% CI 33.6-38.3) and for hemoptysis-related death was 45.1 months (95% CI 43.8-46.4). The overall recurrence rate was 14.6% at 1-month post-BAE, decreased to 5.7% by the 9th month, and rose again to approximately 20% during long-term follow-up. Recurrence was significantly 71% higher in patients with non-massive hemoptysis (46.6%) compared with those with massive hemoptysis (33.8%, OR = 1.71, 95% CI 1.05-2.80, P = 0.03).
CONCLUSIONS: BAE effectively controls life-threatening hemoptysis with favorable long-term survival and acceptable recurrence rates. Optimized management of the underlying pulmonary disease may further improve BAE outcomes and reduce recurrence risk.
METHODS: In this prospective cohort study, patients with hemoptysis undergoing BAE between August 2017 and August 2022 were enrolled and prospectively followed. Clinical characteristics, underlying etiologies, complications, and post-procedural recurrences were prospectively recorded during a 1- to 4-year follow-up period. The survival for each factor was graphed in subgroups by the Kaplan-Meier (KM) curve and presented the estimation of the hazard ratio (HR) with 95% confidence interval (CI) from the univariate Cox proportional hazard (PH) model.
RESULTS: A total of 297 patients (32% female, 58% with massive hemoptysis) were included. The mean survival time (MST) for all-cause mortality was 35.9 months (95% CI 33.6-38.3) and for hemoptysis-related death was 45.1 months (95% CI 43.8-46.4). The overall recurrence rate was 14.6% at 1-month post-BAE, decreased to 5.7% by the 9th month, and rose again to approximately 20% during long-term follow-up. Recurrence was significantly 71% higher in patients with non-massive hemoptysis (46.6%) compared with those with massive hemoptysis (33.8%, OR = 1.71, 95% CI 1.05-2.80, P = 0.03).
CONCLUSIONS: BAE effectively controls life-threatening hemoptysis with favorable long-term survival and acceptable recurrence rates. Optimized management of the underlying pulmonary disease may further improve BAE outcomes and reduce recurrence risk.