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Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study
  1. Hideo Ishikawa1,
  2. Masahiko Hara2,
  3. Misaki Ryuge1,
  4. Jun Takafuji1,
  5. Mihoko Youmoto1,
  6. Masanori Akira3,
  7. Yukio Nagasaka4,
  8. Daijiro Kabata2,
  9. Kouji Yamamoto2,
  10. Ayumi Shintani2
  1. 1Hemoptysis and Pulmonary-Circulation Center, Kishiwada Eishinkai Hospital, Kishiwada, Japan
  2. 2Department of Clinical Epidemiology and Biostatics, Osaka University Graduate School of Medicine, Suita, Japan
  3. 3Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan
  4. 4Rakuwakai Kyoto Pulmonary Center, Rakuwakai Otowa Hospital, Kyoto, Japan
  1. Correspondence to Dr Masahiko Hara; masahiko.hara{at}dmi.med.osaka-u.ac.jp

Abstract

Objectives Evidence on the safety and long-term efficacy of super selective bronchial artery embolisation (ssBAE) using platinum coils in patients with haemoptysis is insufficient. The objective of the present study was to evaluate the safety and the 3-year postprocedure haemoptysis-free survival rate of de novo elective ssBAE using platinum coils rather than particles for the treatment of haemoptysis.

Design A single-centre retrospective observational study.

Setting Hemoptysis and Pulmonary Circulation Center in Japan.

Participants A total of 489 consecutive patients with massive and non-massive haemoptysis who underwent de novo elective ssBAE without malignancy or haemodialysis.

Interventions ssBAE using platinum coils. All patients underwent CT angiography before the procedure for identifying haemoptysis-related arteries (HRAs) and for procedural planning.

Primary and secondary outcome measures The composite of the 3-year recurrence of haemoptysis and mortality from the day of the last ssBAE session. Each component of the primary end point and procedural success defined as successful embolisation of all target HRAs were also evaluated.

Results The median patient age was 69 years, and 46.4% were men. The total number of target vessels was 4 (quartile 2–7), and the procedural success rate was 93.4%. There were 8 (1.6%) major complications: 1 aortic dissection, 2 symptomatic cerebellar infarctions and 5 mediastinal haematoma cases. The haemoptysis-free survival rates were estimated by the Kaplan-Meier analysis at 86.9% (95% CI 83.7% to 90.2%) at 1 year, 79.4% (74.8% to 84.3%) at 2 years and 57.6% (45.1% to 73.4%) at 3 years. Although not statistically significant by the adjusted analysis of variance with multiple imputation of missing variables, cryptogenic haemoptysis tended to show the most favourable outcome and non-tuberculous mycobacterium showed the worst outcome (adjusted p=0.250).

Conclusions We demonstrated the safety and long-term efficacy of elective ssBAE using platinum coils and established that it can be a valuable therapeutic option for treating patients with haemoptysis.

  • Bronchial artery embolization
  • Computed tomography angiography
  • Coil
  • Hemoptysis

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors HI, MH and MR had full access to all of the study data and take responsibility for the integrity of the data and accuracy of the data analysis, including and especially any adverse effects. HI, MH, MR, JT, MY, MA, YN, DK, KY and AS contributed substantially to the study design, data analysis and interpretation, and to the writing and final approval of the manuscript.

  • Funding This study was supported by an independent Boston Scientific Corporation Investigator-Initiated Research Grant.

  • Competing interests None declared.

  • Ethics approval The study protocol complied with the Helsinki Declaration standards and was approved by the Ethical Committee of the EHPC (approval number 2012–02).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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