Abstract：
BACKGROUND: A retrospective observational study of the short-term efficacy and safety of using glue embolization, namely n-butyl-2-cyanoacrylate (NBCA), in bronchial artery embolization (BAE) and comparison with the literature. The main aim of the study is to display the safety of this embolic material through standardization of interventional procedure for consideration of NBCA as a possible primary embolic agent in cases of BAE.
METHODS: A total of 35 BAE was performed in 31 patients with acute haemoptysis after failure of bronchoscopic therapy using NBCA. The mean age was 56 years with 22 male patients. Pre-interventional bronchoscopy and computed tomographic angiography were performed. In 35 cases, embolization was performed exclusively with NBCA. One patient in combination with coils and one with particles and coils. The 1:4 NBCA-to-Lipiodol mixture was most commonly used. Post-interventional bronchoscopy was performed after 24 h.
RESULTS: Technical success was possible in all cases. Clinical success was achieved in 94.3%. There was a mortality rate of 6.5% within 48 h. No other embolization related major complications were noticed. A minor complication of temporary ischaemia of the bronchial mucosa. No reperfusion of the embolized vessel, however with rebleeding in four patients from different primarily not embolized bronchial arteries.
CONCLUSIONS: Despite previous concerns about its safety based on previous reports and in line with recent studies, we conclude that NBCA is a safe and effective embolic agent to perform BAE in cases of acute haemoptysis if performed according to a clear standard operating procedure as described with a possible superiority over embolic agents. Further blinded prospective comparative studies are necessary.
METHODS: A total of 35 BAE was performed in 31 patients with acute haemoptysis after failure of bronchoscopic therapy using NBCA. The mean age was 56 years with 22 male patients. Pre-interventional bronchoscopy and computed tomographic angiography were performed. In 35 cases, embolization was performed exclusively with NBCA. One patient in combination with coils and one with particles and coils. The 1:4 NBCA-to-Lipiodol mixture was most commonly used. Post-interventional bronchoscopy was performed after 24 h.
RESULTS: Technical success was possible in all cases. Clinical success was achieved in 94.3%. There was a mortality rate of 6.5% within 48 h. No other embolization related major complications were noticed. A minor complication of temporary ischaemia of the bronchial mucosa. No reperfusion of the embolized vessel, however with rebleeding in four patients from different primarily not embolized bronchial arteries.
CONCLUSIONS: Despite previous concerns about its safety based on previous reports and in line with recent studies, we conclude that NBCA is a safe and effective embolic agent to perform BAE in cases of acute haemoptysis if performed according to a clear standard operating procedure as described with a possible superiority over embolic agents. Further blinded prospective comparative studies are necessary.
摘要：
背景：对使用胶水栓塞的短期疗效和安全性的回顾性观察性研究，即2-氰基丙烯酸正丁酯(NBCA)，支气管动脉栓塞术(BAE)与文献比较。该研究的主要目的是通过介入程序的标准化来显示这种栓塞材料的安全性，以将NBCA视为BAE病例中可能的主要栓塞剂。
方法：31例急性咯血患者经支气管镜NBCA治疗失败后，共进行了35例BAE。平均年龄56岁，男性22例。进行了介入前支气管镜检查和计算机断层扫描血管造影。在35个案例中，仅使用NBCA进行栓塞。一名患者与线圈组合，一名患者与颗粒和线圈组合。最常用的是1:4NBCA与碘油的混合物。24h后进行介入后支气管镜检查。
结果：技术上的成功在所有情况下都是可能的。临床成功率为94.3%。48h内死亡率为6.5%，未发现其他栓塞相关的主要并发症。支气管粘膜暂时性缺血的轻微并发症。栓塞血管没有再灌注,然而，四名患者主要来自不同的未栓塞支气管动脉。
结论：尽管根据以前的报告和最近的研究，对其安全性存在担忧，我们得出的结论是,在急性咯血病例中,如果按照明确的标准操作程序进行,NBCA是一种安全有效的栓塞剂,可能优于栓塞剂.进一步盲化的前瞻性比较研究是必要的。
方法：31例急性咯血患者经支气管镜NBCA治疗失败后，共进行了35例BAE。平均年龄56岁，男性22例。进行了介入前支气管镜检查和计算机断层扫描血管造影。在35个案例中，仅使用NBCA进行栓塞。一名患者与线圈组合，一名患者与颗粒和线圈组合。最常用的是1:4NBCA与碘油的混合物。24h后进行介入后支气管镜检查。
结果：技术上的成功在所有情况下都是可能的。临床成功率为94.3%。48h内死亡率为6.5%，未发现其他栓塞相关的主要并发症。支气管粘膜暂时性缺血的轻微并发症。栓塞血管没有再灌注,然而，四名患者主要来自不同的未栓塞支气管动脉。
结论：尽管根据以前的报告和最近的研究，对其安全性存在担忧，我们得出的结论是,在急性咯血病例中,如果按照明确的标准操作程序进行,NBCA是一种安全有效的栓塞剂,可能优于栓塞剂.进一步盲化的前瞻性比较研究是必要的。
