• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Chronic Disease

Recurrent hemoptysis is effectively treated by bronchial artery embolization

byXiaofan PanandDylan Wolman
October 16, 2015
in Chronic Disease, Imaging and Intervention, Pulmonology
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Bronchial artery embolization (BAE) effectively treated patients with hemoptysis with minimal recurrent bleeding and complications, except in those with sarcoidosis, who displayed a significantly higher risk of recurrent bleeding and death as compared to patients with other chronic lung diseases.

2. Comparisons of rates of change in measurements of pulmonary function prior to and following intervention indicated that BAE did not accelerate deterioration in lung function.

Evidence Rating Level: 3 (Fair)

Study Rundown: BAE is a well-established, non-surgical procedure in the management of hemoptysis, or the coughing up of blood. Hemoptysis occurs in the setting of chronic inflammatory conditions of both infectious and noninfectious etiologies; alterations in blood flow and distribution result in expectoration of blood that originates from the systemic arterial supply to the pulmonary airway. While mild hemoptysis may be conservatively managed medically, major hemoptysis may lead to asphyxiation and exsanguination and should therefore be promptly assessed and treated with BAE as a first-line intervention. Although BAE as initial treatment of hemoptysis is a safe and useful therapy, recurrent hemoptysis in patients following successful BAE with chronic lung disease may occur due to the continued presence of inflammation, recanalization of a previously embolized bronchial artery, or bleeding from another nonembolized vessel. Recurrent bleeding following BAE leading to additional interventions is a significant concern and the effect of these interventions on recurrence, mortality and long-term pulmonary function is poorly understood. The present study retrospectively examined a cohort of patients who underwent BAE for a heterogenous array of lung conditions and tabulated the effect of BAE on hemoptysis recurrence, pulmonary function, and other procedure-related complications. The intervention was effective in treatment of hemoptysis, although patients whose hemoptysis resulted due to underlying sarcoidosis had a greater likelihood of recurrent bleeding and subsequent mortality. Additionally, measurements of pulmonary function across patient groups showed that BAE did not significantly contribute to deterioration in lung function. Strengths of the study included the variety of underlying etiologies of hemoptysis included, but the study was limited by its retrospective design and small included cohort from a single medical center, thereby restricting generalizability.

Click to read the study in the Journal of Vascular and Interventional Radiology

Relevant Reading: Bronchial artery embolization in adults with cystic fibrosis: impact on the clinical course and survival

In-Depth [retrospective cohort]: A database search retrospectively identified 69 suitable candidates who underwent 97 total BAE procedures (n = 1–7 per patient) over an 11 year interval at a tertiary medical center in Philadelphia, PA. Patients were followed post-intervention and their outcomes in terms of pulmonary function changes, mortality, and recurrent bleeding over time were tabulated using a Kaplan–Meier curve. Comparison of the results of BAE for different underlying disease processes was performed to determine the technical and clinical success of BAE for various etiologies of hemoptysis. The baseline causes of hemoptysis in these patients included sarcoidosis (19%), cystic fibrosis (17%), pneumonia (16%), lung cancer (11%), COPD (9%), and bronchiectasis, tuberculosis, pulmonary hypertension, and various chronic inflammatory disease (each 1-4%.) 87 out of the 97 BAE procedures attempted delivered the embolic agent successfully, yielding a 90% technical success rate. Among technically successful procedures, clinical success rates were higher at 24 hours (82%) than at 30 days (68%); with a median time to recurrent bleeding of 29 days among patients with sarcoidosis and median time to rebleeding for those without sarcoidosis of 293 days (p = 0.0013). 75% of procedures resulted in complete recovery of symptoms at 24 hours, which dropped to 48% at 30 days. 70% patients (48) did not experience recurrent bleeding throughout the duration of the study, while 7% (5) patients required another bronchoscopy or additional embolization (23%). Evaluation of deaths in patients with sarcoidosis compared with those without the disease gave a hazard ratio of 4 (CI95: 2.6–14.6). Rates of change on pulmonary function parameters were significantly different: forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) changed between the pre- and post-embolization state (FEV1 p = 0.0048; FVC p < 0.0001), with an improvement following the intervention (FEV1 0.8%/year; FVC 1%/year) as compared to a baseline decline prior to treatment (FEV1 −1.6%/year; FVC −1.4%/year). Recurrent hemoptysis requiring repeat BAE or bronchoscopy at 1, 2, and 5 years following initial intervention were performed in 39%, 47%, and 51% of subjects, respectively.

RELATED REPORTS

No Content Available

Image: PD

©2015 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: bronchial alveolar embolization (BAE)hemoptysis
Previous Post

Dietary supplements linked to 23,000 emergency visits per year

Next Post

Budesonide linked with decreased bronchopulmonary dysplasia in preterm infants

RelatedReports

No Content Available
Next Post
No decrease in infant mortality with maternal micronutrient supplementation in Bangladesh

Budesonide linked with decreased bronchopulmonary dysplasia in preterm infants

Nivolumab may be effective in platinum-resistant ovarian cancer

Adjuvant hormone therapy may improve survival in ovarian cancer

Maternal midpregnancy glucose linked to increased risk of congenital heart disease

Maternal midpregnancy glucose linked to increased risk of congenital heart disease

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Addition of fludrocortisone to hydrocortisone is beneficial in management of septic shock
  • Surveillance testing of staff at nursing facilities reduces resident COVID-19 mortality
  • Childhood maltreatment may cause mental health problems
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options