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Bronchial artery embolisation can be equally
safe and effective in the management of chronic
recurrent haemoptysis
Samuel Lee,
Johnny WM Chan,
Susan CH Chan,
YH Chan,
TL Kwan,
MK Chan,
CK Ng,
MP Lee,
WL Law,
Thomas YW Mok
Department of Medicine, Queen Elizabeth Hospital, 30 Gascoigne
Road, Kowloon, Hong Kong
OBJECTIVE. To examine the efficacy and safety of bronchial artery
embolisation in patients with acute major haemoptysis and
those with chronic recurrent haemoptysis.
DESIGN. Retrospective review of clinical records.
SETTING. Regional hospital, Hong Kong.
PATIENTS. Clinical records of 70 consecutive patients who had undergone
bronchial artery embolisation in Queen Elizabeth Hospital from
1998 to 2003 were reviewed. Altogether 74 bronchial artery
embolisation procedures were attempted, 46 (62%) for acute
major haemoptysis, and 28 (38%) for chronic recurrent bleeding.
Follow-up data were available for 32 patients.
MAIN OUTCOME MEASURES. After bronchial artery embolisation, the Kaplan-Meier method
and log-rank tests were used to compare the probability of
recurrence in the two patient categories.
RESULTS. Overall immediate control was attained following 99% of the
procedures, with a complication rate of 13%; all complications
were mild and self-limiting. For the 32 patients (19 having acute
major haemoptysis and 13 having chronic recurrent bleeding)
with follow-up data available, the overall recurrence rate was
36% (26% in the acute and 47% in chronic group). No statistically
significant difference in recurrence probability between the two
groups was observed (P=0.24). Presence of active pulmonary
tuberculosis was associated with increased risk of recurrence
(P=0.005).
CONCLUSION. Bronchial artery embolisation was noted to be effective and safe
in both acute major and chronic recurrent haemoptysis.
Hong Kong Med J 2008;14:14-20
Key words: Bronchial arteries; Bronchiectasis;
Embolization, therapeutic; Hemoptysis;
Recurrence
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