Abstract：
BACKGROUND: Bronchial artery embolization (BAE) using particles is an established treatment for hemoptysis. The use of polyvinyl alcohol (PVA) with a particle size of 300 µm or larger is thought to reduce the risk of non-target embolization but may result in more proximal vessel occlusion than is ideal, resulting in a high rate of early recurrent hemorrhage.
OBJECTIVE: This study evaluates the safety and efficacy of BAE using PVA particles with a size of less than 300 µm.
METHODS: All patients who underwent BAE between 2010 and 2022 at a tertiary center were included. Demographic data, etiology and volume of hemoptysis, technical and clinical success, procedure-related complications, and follow-up information were collected from patients\' electronic records. 150-250 µm PVA particles were used to commence embolization in all patients with the subsequent use of larger-sized particles in some individuals. The Kaplan-Meier method was used to estimate recurrence and survival rates.
RESULTS: One hundred forty-four patients underwent 189 embolization procedures between 2010 and 2022 and were followed up for a median of 35 months [IQR 19-89]. 150 µm to 250 µm PVA particles were used as the sole embolic agent in 137 cases. Hemoptysis recurred within 30 days in 7%. The median time to repeat intervention was 144 days [IQR 42-441]. Seventeen out of 144 patients had a pulmonary artery branch pseudoaneurysm. The rate of major complications was 1% with no instances of stroke or spinal artery ischemia. Thirty-day mortality was 2% (4/189).
CONCLUSIONS: BAE using 150-250 µm PVA particles is safe and effective with few complications and low rates of early hemoptysis recurrence.
CONCLUSIONS: BAE using small particles is likely to improve outcomes, particularly the rate of early recurrence, in patients with hemoptysis, without an increase in procedural complications.
CONCLUSIONS: BAE is a safe and effective treatment for patients with hemoptysis. Using small PVA particles in BAE has few complications and low rates of early recurrence. Pulmonary artery pseudoaneurysms should be actively sought in those with hemoptysis undergoing BAE.
OBJECTIVE: This study evaluates the safety and efficacy of BAE using PVA particles with a size of less than 300 µm.
METHODS: All patients who underwent BAE between 2010 and 2022 at a tertiary center were included. Demographic data, etiology and volume of hemoptysis, technical and clinical success, procedure-related complications, and follow-up information were collected from patients\' electronic records. 150-250 µm PVA particles were used to commence embolization in all patients with the subsequent use of larger-sized particles in some individuals. The Kaplan-Meier method was used to estimate recurrence and survival rates.
RESULTS: One hundred forty-four patients underwent 189 embolization procedures between 2010 and 2022 and were followed up for a median of 35 months [IQR 19-89]. 150 µm to 250 µm PVA particles were used as the sole embolic agent in 137 cases. Hemoptysis recurred within 30 days in 7%. The median time to repeat intervention was 144 days [IQR 42-441]. Seventeen out of 144 patients had a pulmonary artery branch pseudoaneurysm. The rate of major complications was 1% with no instances of stroke or spinal artery ischemia. Thirty-day mortality was 2% (4/189).
CONCLUSIONS: BAE using 150-250 µm PVA particles is safe and effective with few complications and low rates of early hemoptysis recurrence.
CONCLUSIONS: BAE using small particles is likely to improve outcomes, particularly the rate of early recurrence, in patients with hemoptysis, without an increase in procedural complications.
CONCLUSIONS: BAE is a safe and effective treatment for patients with hemoptysis. Using small PVA particles in BAE has few complications and low rates of early recurrence. Pulmonary artery pseudoaneurysms should be actively sought in those with hemoptysis undergoing BAE.
摘要：
背景：使用颗粒的支气管动脉栓塞（BAE）是咯血的既定治疗方法。使用粒径为300μm或更大的聚乙烯醇（PVA）被认为可以降低非目标栓塞的风险，但可能导致比理想情况更多的近端血管闭塞。导致早期复发性出血率高。
目的：本研究使用尺寸小于300µm的PVA颗粒评估BAE的安全性和有效性。
方法：纳入2010年至2022年在三级中心接受BAE的所有患者。人口统计数据,咯血的病因和体积，技术和临床成功，手术相关并发症,并从患者的电子记录中收集随访信息.在所有患者中使用150-250µmPVA颗粒开始栓塞，随后在某些个体中使用较大尺寸的颗粒。采用Kaplan-Meier法估计复发率和生存率。
结果：在2010年至2022年期间，144例患者接受了189例栓塞手术，中位随访时间为35个月[IQR19-89]。在137例中，使用150µm至250µm的PVA颗粒作为唯一的栓塞剂。咯血在30天内复发7%。重复干预的中位时间为144天[IQR42-441]。144例患者中有17例患有肺动脉分支假性动脉瘤。主要并发症的发生率为1％，无中风或脊髓动脉缺血。30天死亡率为2%（4/189）。
结论：使用150-250μmPVA颗粒的BAE安全有效，并发症少，早期咯血复发率低。
结论：使用小颗粒的BAE可能会改善结果，特别是早期复发率，咯血患者，而不会增加手术并发症。
结论：BAE是咯血患者安全有效的治疗方法。在BAE中使用小PVA颗粒并发症少，早期复发率低。在进行BAE的咯血患者中，应积极寻找肺动脉假性动脉瘤。
目的：本研究使用尺寸小于300µm的PVA颗粒评估BAE的安全性和有效性。
方法：纳入2010年至2022年在三级中心接受BAE的所有患者。人口统计数据,咯血的病因和体积，技术和临床成功，手术相关并发症,并从患者的电子记录中收集随访信息.在所有患者中使用150-250µmPVA颗粒开始栓塞，随后在某些个体中使用较大尺寸的颗粒。采用Kaplan-Meier法估计复发率和生存率。
结果：在2010年至2022年期间，144例患者接受了189例栓塞手术，中位随访时间为35个月[IQR19-89]。在137例中，使用150µm至250µm的PVA颗粒作为唯一的栓塞剂。咯血在30天内复发7%。重复干预的中位时间为144天[IQR42-441]。144例患者中有17例患有肺动脉分支假性动脉瘤。主要并发症的发生率为1％，无中风或脊髓动脉缺血。30天死亡率为2%（4/189）。
结论：使用150-250μmPVA颗粒的BAE安全有效，并发症少，早期咯血复发率低。
结论：使用小颗粒的BAE可能会改善结果，特别是早期复发率，咯血患者，而不会增加手术并发症。
结论：BAE是咯血患者安全有效的治疗方法。在BAE中使用小PVA颗粒并发症少，早期复发率低。在进行BAE的咯血患者中，应积极寻找肺动脉假性动脉瘤。
