Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.991
Filtrar
1.
Kyobu Geka ; 75(13): 1083-1087, 2022 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-36539223

RESUMO

A 55-year-old woman was suspected of having hilar lymph node enlargement on a routine examination of the chest computed tomography( CT) scan at our hospital. On further examination, thoracic contrast CT and bronchial arteriography showed prominent dilation and meandering of the right bronchial artery with an aneurysm which formed a fistula to the pulmonary artery A7 at its distal end. Diagnosed as racemose hemangioma of bronchial artery with pulmonary artery fistula, we performed a surgical resection by open thoracotomy on the second day following bronchial artery embolization( BAE). No recurrence was observed in the five years of follow-up period after surgery. Therefore, surgical resection for asymptomatic racemose hemangioma of bronchial artery with bronchial artery-pulmonary artery fistula can be considered an effective method for the long-term prevention of bleeding.


Assuntos
Aneurisma , Embolização Terapêutica , Fístula , Hemangioma , Feminino , Humanos , Pessoa de Meia-Idade , Artérias Brônquicas/diagnóstico por imagem , Artérias Brônquicas/cirurgia , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/cirurgia , Hemangioma/diagnóstico por imagem , Hemangioma/cirurgia , Aneurisma/terapia , Embolização Terapêutica/métodos
2.
BMC Pulm Med ; 22(1): 424, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36397043

RESUMO

BACKGROUND: Massive hemoptysis is a rare but potentially life-threatening condition of patients with cystic fibrosis (CF) and advanced pulmonary disease. Hypertrophied bronchial arteries are understood to cause massive hemoptysis when rupturing. Risk factors to predict massive hemoptysis are scarce and bronchial artery diameters are not part of any scoring system in follow-up of patients with CF. Aim of this study was to correlate bronchial artery diameter with massive hemoptysis in CF. METHODS: Bronchial artery and non-bronchial systemic artery diameters were measured in contrast enhanced computed tomography (CT) scans in patients with massive hemoptysis and compared to patients with end-stage CF and no history of hemoptysis. Demographic and clinical data and side of bronchial artery/non-bronchial systemic artery hypertrophy and coil embolization were documented. RESULTS: In this retrospective multicenter study 33 patients with massive hemoptysis were included for bronchial artery/non-bronchial systemic artery diameter measurements, (13 female, 20 male, median age 30 years (18-55)). Bronchial artery diameters were significantly larger in the case group than in the control group with median 4 mm (2.2-8.2 mm), and median 3 mm (1-7 mm), respectively (p = 0.002). Sensitivity of bronchial arteries ≥ 3.5 mm to be associated with hemoptysis was 0.76 and specificity 0.71 with ROC creating an area under the curve of 0.719. If non-bronchial systemic arteries were present, they were considered culprit and embolized in 92% of cases. CONCLUSION: Bronchial arteries ≥ 3.5 mm and presence of hypertrophied non-bronchial systemic arteries correlate with massive hemoptysis in patients with CF and might serve as risk predictor for massive hemoptysis. Therefore, in patients with advanced CF we propose CT scans to be carried out as CT angiography to search for bronchial arteries ≥ 3.5 mm and for hypertrophied non-bronchial systemic arteries as possible risk factors for massive hemoptysis.


Assuntos
Fibrose Cística , Embolização Terapêutica , Humanos , Masculino , Feminino , Adulto , Artérias Brônquicas/diagnóstico por imagem , Fibrose Cística/complicações , Embolização Terapêutica/métodos , Hemoptise/etiologia , Hemoptise/terapia , Angiografia/efeitos adversos , Angiografia/métodos
3.
Zhonghua Jie He He Hu Xi Za Zhi ; 45(11): 1097-1102, 2022 Nov 12.
Artigo em Chinês | MEDLINE | ID: mdl-36344226

RESUMO

Objective: To estimate the value of multidetector computed tomography angiography (MDCTA) and image analysis before bronchial artery embolization (BAE) in the treatment of hemoptysis. Methods: A total of 165 patients with hemoptysis who underwent BAE at the Department of Interventional Radiology of Xiangyang Central Hospital from August 2017 to June 2021 were retrospectively analyzed and divided into two groups: MDCTA group [with preoperative MDCTA, 88 patients,63 males and 25 females,aged 23 to 87(62.6±12.3) years] and control group [77 patients, 52 males and 25 females, aged 26 to 83 (59.8±12.7) years]. The number of bronchial arteries and non-bronchial systemic arteries, and clinical success rate were compared between the two groups. Comparisons within groups were performed using the t-test or nonparametric paired Wilcoxon test for quantitative data with paired design, while comparisons between groups were performed using the t-test for the mean of two independent samples or the nonparametric Mann-Whitney U test for independent samples and comparisons between groups were performed using the chi-square test. Results: The number of orthotopic and ectopic bronchial arteries found in BAE procedure in the MDCTA group was significantly higher than that in the control group [1.77±0.72 vs. 1.42±0.82, P=0.003; 0 (0, 0) vs. 0 (0, 0), P=0.033, respectively]; in the MDCTA group, the numbers of orthotopic and ectopic bronchial arteries found by MDCTA were significantly higher than those found in BAE procedure [2.22±0.63 vs. 1.77±0.72, P<0.001; 0 (0, 0) vs. 0 (0, 0), P=0.005, respectively]. The number of non-intercostal arteries found by MDCTA in the MDCTA group was significantly higher than that in the control group [0 (0, 0) vs. 0 (0, 0), P=0.038]. Hemostatic success was significantly higher in the MDCTA group than that in the control group (88.6% vs. 68.8%, P=0.002). Conclusions: MDCTA and image analysis help to detect more bronchial arteries and improve the hemostatic success rate before bronchial artery embolization in the treatment of hemoptysis.


Assuntos
Embolização Terapêutica , Hemostáticos , Masculino , Feminino , Humanos , Artérias Brônquicas/diagnóstico por imagem , Hemoptise/diagnóstico por imagem , Hemoptise/terapia , Tomografia Computadorizada Multidetectores/métodos , Estudos Retrospectivos , Angiografia/métodos , Embolização Terapêutica/métodos , Resultado do Tratamento
4.
BMC Pulm Med ; 22(1): 394, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36319977

RESUMO

BACKGROUND: To retrospectively evaluate the effectiveness of bronchial artery embolization (BAE) compared with conservative therapy for the treatment of frequent hemoptysis caused by bronchiectasis. METHODS: From January 2015 to December 2019, consecutive patients who were admitted due to frequent (more than three times per year) bronchiectasis-related hemoptysis were retrospectively reviewed. Those who were treated with either BAE (n = 69) or conservative therapy (n = 47) were enrolled for analysis. The technical success, clinical success, and complications of the BAE procedure were evaluated. Long-term hemoptysis-free survival rates and clinical success were compared between patients in the BAE group and patients in the conservative group. A Cox proportional hazard regression model was used to identify the predictors of recurrent hemoptysis. RESULTS: The technical success rate was 100% for the BAE procedure, and clinical success was achieved in 92.8% (64 of 69) of cases. No major procedure-related complications occurred, and minor complications were observed in 16 cases (23.2%). The 1-, 2-, and 3-year hemoptysis-free survival rates were 88.3, 71.3, and 66.2%, respectively, for the BAE group and 31.9, 17.6, and 2.5%, respectively, for the conservative treatment group (P <  0.001). Multivariate analysis showed that BAE was a protective factor against recurrent hemoptysis in treated patients. In addition, the presence of cystic bronchiectasis was the only independent risk factor for rebleeding in the whole population and in the BAE group. CONCLUSIONS: BAE may provide an effective option for patients with frequent bronchiectasis-related hemoptysis, especially for those without cystic bronchiectasis.


Assuntos
Bronquiectasia , Embolização Terapêutica , Humanos , Artérias Brônquicas , Estudos Retrospectivos , Recidiva , Hemoptise/etiologia , Embolização Terapêutica/métodos , Bronquiectasia/complicações , Resultado do Tratamento
5.
Technol Cancer Res Treat ; 21: 15330338221131167, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36226988

RESUMO

Purpose:This pilot study was designed to assess the technical feasibility and safety of bronchial artery chemoembolization with radiopaque doxorubicin eluting beads (DEB-BACE) in patients with malignant hemoptysis from pulmonary metastasis. Materials & Methods: Four patients underwent DEB-BACE using 70-150 µm radiopaque DEB (LC Beads LUMI, Boston Scientific). Beads delivery and deposition were assessed under fluoroscopy and cone beam computed tomography (CT), respectively. Results: All 4 procedures were technically successful. Beads delivery and deposition were successfully visualized under fluoroscopy and cone beam CT guidance in all cases. Hemoptysis was resolved after embolization in all 4 patients. There were no adverse events or immediate or early complications after DEB-BACE. Two patients (50%) required repeat DEB-BACE within 1 week due to recurrent hemoptysis, and 1 patient had DEB-BACE 1.5 years later due to recurrent hemoptysis from the contralateral lung. All targeted lesions decreased in size in follow-up studies (mean 16 months, range 1-33 months). One patient died of progressive cancer disease invading the heart 1 month after DEB-BACE. Conclusions: DEB-BACE using radiopaque LC Beads LUMI loaded with doxorubicin is technically feasible and safe for controlling hemoptysis and cancer progression in patients with metastatic lung tumors. Visualization of beads delivery under fluoroscopy and deposition of beads under cone beam CT facilitate delivery of beads and embolization of bronchial arteries.


Assuntos
Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Neoplasias Pulmonares , Artérias Brônquicas/patologia , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/métodos , Doxorrubicina , Hemoptise/etiologia , Hemoptise/terapia , Humanos , Neoplasias Hepáticas/terapia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/tratamento farmacológico , Projetos Piloto , Estudos Retrospectivos , Resultado do Tratamento
6.
J Cancer Res Ther ; 18(5): 1432-1435, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36204893

RESUMO

Objective: To evaluation the clinical efficacy and safety of bronchial artery chemoembolization (BACE) combined with apatinib for treatment of advanced central lung squamous cell carcinoma (LSCC). Methods: Forty-seven patients with pathologically diagnosed stage IIIB or IV central LSCC that was not resectable were selected among hospital patients presenting after November 2016. Twenty-one patients were treated with BACE combined with apatinib; the remaining patients served as a control group treated with BACE alone. Objective response rate (ORR) and disease control rate (DCR) were evaluated with postoperative contrast-enhanced CT scans at 3, 6, and 12 months. Progression-free survival (PFS) curves were used to evaluate curative effects. Adverse events were recorded to assess safety. Results: BACE operations were successfully completed in all 47 patients. Significant differences were found at six and 12 months (P < 0.05). Median PFS was 322 days in the observation group and 209 days in the control group: a statistically significant difference (P = 0.042). One-year survival rates were 76.19% and 46.15% for observation and control patients, respectively; this difference was also significant (P = 0.037). Three patients in the observation group received emergency interventional embolization for hemoptysis, and patients with grade III or greater adverse reaction events (AE) accounted for 19.05% of patients (4/21); these subjects improved or were controlled after active treatment. Conclusion: BACE combined with apatinib is effective for treatment of advanced central LSCC, with definite short-term efficacy, controllable risk, and high safety. Investigation with a larger sample size is warranted to confirm study results.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Carcinoma de Células Escamosas , Neoplasias Pulmonares , Artérias Brônquicas/patologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma de Células Escamosas/tratamento farmacológico , Humanos , Pulmão/patologia , Neoplasias Pulmonares/tratamento farmacológico , Piridinas
7.
Contrast Media Mol Imaging ; 2022: 2471039, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36072634

RESUMO

The clinical efficacy, serum tumor markers, and miR-34 expression levels of bronchial artery embolization (BAE) in patients with lung cancer with hemoptysis are investigated. 92 patients with lung cancer hemoptysis treated in our hospital from January 2019 to December 2021 are randomly selected, and 92 patients are randomly divided into the conservative group and the BAE group according to the number table method, with 46 patients in each group. The efficacy, overall survival (OS) rate, coagulation function, hemoptysis volume, serum tumor markers, and miR-34 expression are compared among all groups at different time points. The experimental results show that the BAE treatment can promote the expression of miR-34 and inhibit the expression of tumor markers, so it can improve the efficacy of patients with lung cancer hemoptysis, improve the symptoms of hemoptysis and coagulation function, and prolong the life cycle of patients.


Assuntos
Neoplasias Pulmonares , MicroRNAs , Biomarcadores Tumorais , Artérias Brônquicas , Hemoptise/terapia , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/terapia , MicroRNAs/genética , Estudos Retrospectivos
8.
Indian J Med Res ; 155(3&4): 356-363, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-36124510

RESUMO

Background & objectives: Haemoptysis in children is potentially life-threatening. In most cases, the bleeding arises from the systemic circulation, and in 5-10 per cent of cases, it arises from the pulmonary circulation. The role of computed tomography angiography (CTA) in this setting is important. This study was undertaken (i) to study the role of single-phase split-bolus dual energy contrast-enhanced multidetector row CTA (DECTA) in the evaluation of haemoptysis in children; (ii) to analyze the patterns of abnormal vascular supply in the various aetiologies encountered. Methods: A retrospective study of 86 patients who underwent split bolus DECTA for the evaluation of haemoptysis was performed. Final diagnoses were categorized as normal computed tomography, active tuberculosis (TB), post-infectious sequelae, non-TB active infection, cystic fibrosis (CF), non-CF bronchiectasis, congenital heart disease (CHD), interstitial lung disease, vasculitis, pulmonary thromboembolism and idiopathic pulmonary haemosiderosis. Abnormal bronchial arteries (BAs) and non-bronchial systemic collateral arteries (NBSCs) were assessed for number and site and their correlation with underlying aetiologies. Results: A total of 86 patients (45 males, age from 0.3 to 18 yr, mean 13.88 yr) were included in the study; among these only two patients were less than five years of age. The most common cause of haemoptysis was active infection (n=30), followed by bronchiectasis (n=18), post-infectious sequelae (n=17) and CHD (n=7). One hundred and sixty five abnormal arteries were identified (108 BA and 57 NBSC), and were more marked in bronchiectasis group. Interpretation & conclusions: Active infections and bronchiectasis are the most common causes of haemoptysis in children. While post-infectious sequelae are less common, in patients with haemoptysis, the presence of any abnormal arteries correlates with a more frequent diagnosis of bronchiectasis. NBSCs are more common in post-infectious sequelae and CHD.


Assuntos
Artérias Brônquicas , Bronquiectasia , Hemoptise , Adolescente , Artérias Brônquicas/anormalidades , Artérias Brônquicas/diagnóstico por imagem , Bronquiectasia/complicações , Bronquiectasia/diagnóstico por imagem , Criança , Pré-Escolar , Angiografia por Tomografia Computadorizada/efeitos adversos , Hemoptise/etiologia , Humanos , Masculino , Estudos Retrospectivos
9.
Respir Res ; 23(1): 257, 2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36127690

RESUMO

BACKGROUND: Bronchial artery embolisation (BAE) is an effective treatment option to control haemoptysis in primary lung cancer. However, no studies have investigated optimal embolisation material for BAE in lung cancer patients. Thus, this study aimed to compare the safety and efficacy of BAE performed using n-butyl-2-cyanoacrylate (NBCA) and polyvinyl alcohol (PVA) particles in primary lung cancer patients to determine which embolic material is better for patients with haemoptysis. METHODS: This retrospective study was approved by the institutional review board, and consent was waived. The rates of hemostasis, complications, procedure time, dose-area product, and haemoptysis-free survival were retrospectively compared between primary lung cancer (non-small cell [n = 111] and small cell [n = 11]) patients who underwent BAE using NBCA (n = 58) or PVA particles (n = 64) between January 2004 and December 2019. Predictors of recurrent haemoptysis were analysed using the Cox proportional hazard regression model. RESULTS: Among 122 patients (mean age, 66 ± 10 years; range 32-86 years; 103 men), more patients in the NBCA group (81.0%; 47 of 58) achieved complete hemostasis than did patients in the PVA group (53.1%; 34 of 64) (P = 0.002). No major complications were observed in either group. The procedure time (36.4 ± 21.6 vs. 56.3 ± 27.4 min, P < 0.001) was shorter, and the dose-area product (58.6 ± 64.0 vs. 233.5 ± 225.0 Gy*cm2, P < 0.001) was smaller in the NBCA group than in the PVA group. The median haemoptysis-free survival was 173.0 in the NBCA group compared with 20.0 days in the PVA group (P < 0.001). The PVA use (P < 0.001) and coagulopathy (P = 0.014) were independent predictors of shortened haemoptysis-free survival. CONCLUSION: BAE using NBCA showed significantly superior initial hemostasis with longer haemoptysis-free survival, shorter procedure time, and reduced radiation dose than BAE using PVA particles. The PVA use and coagulopathy were independent predictors of recurrent haemoptysis. TRIAL REGISTRATION: Retrospectively registered.


Assuntos
Embucrilato , Neoplasias Pulmonares , Adulto , Idoso , Idoso de 80 Anos ou mais , Artérias Brônquicas/diagnóstico por imagem , Embucrilato/efeitos adversos , Hemoptise/diagnóstico , Hemoptise/terapia , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Álcool de Polivinil/efeitos adversos , Estudos Retrospectivos
11.
Eur J Radiol ; 154: 110448, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35917756

RESUMO

PURPOSE: To evaluate the outcome of dual-vessel intervention (DVI), including bronchial or pulmonary arterial embolization (B/PAE), in managing massive hemoptysis caused by cavitary lung lesions (with or without aspergilloma) and identify cavitary angiographic features influencing DVI procedures. METHOD: A retrospective analysis of the medical records and angiograms of 15 patients who underwent DVI for massive hemoptysis was performed. RESULTS: The most frequent causes of cavitary lung lesions were tuberculosis (TB) (8/15, 53%) and bronchiectasis (6/15, 40%). Eight patients were diagnosed with aspergilloma (8/15, 53%). In all, 24 systemic arteries, including the orthotopic and ectopic bronchial arteries and 1 pulmonary artery branch, were embolized in 16 procedures. Clinical success and immediate cessation of hemoptysis were achieved in 12 patients (80%). Hemoptysis was controlled in 10 patients (67%) and recurred in 2 patients (17%), while 1 patient (7%) required repeat embolization. The bronchopulmonary fistula (shunting) rate was 73.3% (11/15). The average fistula emergence time was 1.28 ± 1.27 s (M ± SD), and the average vessel diameter was 3.974 ± 1.57 mm. There were no significant differences in angiographic features, clinical success, or recurrence of cavitary lesions with or without aspergilloma. The complication rates were low, with only transient chest pain and ventricular arrhythmia reported. CONCLUSIONS: BAE is an effective and safe procedure for most cavitary lesions causing massive hemoptysis, and DVI is needed under certain circumstances. High bronchopulmonary fistula rates and early fistula emergence times were observed for cavitary lesions. The DVI strategy depends on the culprit vessel diameter, fistula type, and fistula emergence time.


Assuntos
Embolização Terapêutica , Hemoptise , Brônquios , Artérias Brônquicas/diagnóstico por imagem , Embolização Terapêutica/métodos , Hemoptise/diagnóstico por imagem , Hemoptise/etiologia , Hemoptise/terapia , Humanos , Estudos Retrospectivos , Resultado do Tratamento
12.
Turk Kardiyol Dern Ars ; 50(6): 459-462, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35983652

RESUMO

Hemoptysis, accompanying various chronic lung diseases, some systemic diseases, infections, structural heart diseases, or syndromes is a clinical condition that is quite mortal when it is massive. Hemoptysis is a common complication of Eisenmenger syndrome. Its frequency increases with age. It is an important cause of mortality in patients with Eisenmenger syndrome. Embolization of systemic-pulmonary collateral arteries is an effective method in the treatment of hemoptysis in eligible patients with Eisenmenger syndrome. In this case report, a patient with Eisenmenger syndrome, developed due to large patent ductus arteriosus, received dual pulmonary arterial hypertension-specific treatment, after the development of hemoptysis, medical stabilization was provided with initial inhaled nitric oxide therapy and then treated with bronchial artery embolization without complications is presented.


Assuntos
Complexo de Eisenmenger , Embolização Terapêutica , Artérias Brônquicas/diagnóstico por imagem , Complexo de Eisenmenger/complicações , Complexo de Eisenmenger/terapia , Embolização Terapêutica/efeitos adversos , Hemoptise/etiologia , Hemoptise/terapia , Humanos , Óxido Nítrico
13.
BMJ Case Rep ; 15(8)2022 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-35995460

RESUMO

An African American man in his 30s presented with haemoptysis associated with chronic productive cough, exertional dyspnoea, weight loss and skin lesions. Physical examination was notable for multiple cutaneous plaques over upper extremities and face. CT chest showed bilateral upper lobes cavitations and left upper lobe mass like consolidation. Further workup revealed positive serum aspergillus IgG, respiratory culture grew Aspergillus fumigatus, skin biopsy showed non-caseating granuloma. A final diagnosis of concomitant chronic pulmonary aspergillosis and advanced fibrocavitary pulmonary sarcoidosis with cutaneous involvement was made. The patient was initiated on antifungal therapy without steroids due to the concern of worsening the fungal infection. However, he presented later with worsening haemoptysis requiring bronchial artery embolisation. Surgical intervention was recommended but the patient eventually declined. The patient continued to be followed up closely in the clinic and repeated chest imaging showed stable findings 3 months after initial presentation.


Assuntos
Aspergilose Pulmonar , Sarcoidose Pulmonar , Antifúngicos/uso terapêutico , Aspergillus fumigatus , Artérias Brônquicas , Hemoptise/terapia , Humanos , Masculino , Aspergilose Pulmonar/complicações , Aspergilose Pulmonar/diagnóstico , Aspergilose Pulmonar/tratamento farmacológico , Sarcoidose Pulmonar/complicações , Sarcoidose Pulmonar/tratamento farmacológico
14.
Diagn Interv Radiol ; 28(4): 359-363, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35950280

RESUMO

PURPOSE We aimed to determine the safety and feasibility of transradial access (TRA) in bronchial artery and non-bronchial systemic artery (NBSA) embolization in patients with non-massive hemoptysis. METHODS This retrospective study was approved by the Institutional Review Board. Among the 300 patients treated for hemoptysis with bronchial artery and NBSA embolization between April 2018 and July 2019, 19 procedures in 19 patients were conducted by TRA and were retrospectively analyzed. TRA was considered when the bronchial artery or NBSA originated from the arch vessel or its tributaries. The exclusion criteria of TRA included Barbeau C or D waveform and a radial artery diameter of less than 1.8 mm on ultrasound. TRA was also avoided in cases of the high-origin bronchial artery (i.e., T4 or higher level of the aorta). The hemoptysis-free time was estimated using the Kaplan-Meier method. RESULTS The technical success (i.e., embolization of all target artery with TRA) rate was 94.7% (18 out of 19 patients). In terms of the target arteries, embolization with TRA was technically successful in treating 47 out of 48 arteries (97.9%). The 1-month and 6-month hemoptysis-free rates were 89.5% (17/19) and 73.7% (14/19), respectively. The only adverse event was iatrogenic dissection of the bronchial artery with little clinical significance in 1 patient. No access site complications were identified on post-procedure day 1 ultrasonography. CONCLUSION With proper patient selection, TRA offers a safe and effective approach to embolize the bronchial arteries and NBSAs in patients with hemoptysis.


Assuntos
Artérias Brônquicas , Embolização Terapêutica , Artérias Brônquicas/diagnóstico por imagem , Embolização Terapêutica/métodos , Hemoptise/diagnóstico por imagem , Hemoptise/etiologia , Hemoptise/terapia , Humanos , Estudos Retrospectivos , Resultado do Tratamento
15.
Biomed Res Int ; 2022: 7376844, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35782072

RESUMO

Objective: To investigate the use and the efficacy of bronchial artery chemoembolization combined with 125I seed implantation in advanced non-small-cell lung cancer (NSCLC) therapy based on the medical database. Methods: A total of 102 patients with advanced NSCLC were randomly divided into two groups. The control group was treated with 125I seed implantation, and the observation group was treated with bronchial artery chemoembolization (BACE) combined with 125I seed implantation based on medical database. The clinical efficacy, carcinoembryonic antigen (CEA), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), glycan antigen 125 (CA125), peripheral blood CD3+, CD8+, CD4+/CD8+ T cells, insulin-like growth factor type 1 receptor (IGF-1R), S100 calcium-binding protein A2 (S100A2), long-term efficacy (time to disease progression, six-month survival rate, and one-year survival rate), and safety were then analyzed. Result: The disease remission rate in the observation group was 62.75%, which was higher than that in the control group (41.18%). After 1 month and 3 months of treatment, the levels of serum CYFRA21-1, CEA, CA125, and IGF-1R were lower, while serum S100A2 was higher in the observation group than in the control group (P < 0.05). For safety assessment, we found that the incidences of neutropenia, thrombocytopenia, and gastrointestinal reactions had no statistical differences between two groups. The time to disease progression in the observation group was 129.85 d longer than that in the control group, 89.74 d, and the six-month survival rate and 1-year survival rate were higher in the observation group relative to the control group. Conclusion: Medical database-based BACE combined with 125I seed implantation in the therapy of advanced NSCLC patients has definite efficacy with certain safety, which can enhance antitumor effect and prolong survival rate in advanced NSCLC patients.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Antígenos de Neoplasias , Artérias Brônquicas , Antígeno Ca-125 , Antígeno Carcinoembrionário , Carcinoma Pulmonar de Células não Pequenas/terapia , Progressão da Doença , Humanos , Radioisótopos do Iodo , Queratina-19 , Neoplasias Pulmonares/terapia
17.
Pneumologie ; 76(8): 552-559, 2022 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-35878603

RESUMO

Blood supply to the lungs is carried out by the pulmonary and bronchial-arterial system. The bronchial-arterial vessels are involved in supplying the small airways all the way up to the terminal bronchioles. The bronchial-arterial system is also necessary for the regulation of airway temperature, humidity and mucociliary clearance. Chronic ischaemia of the small airways due to damage or injury to bronchial arterial supply increases the risk of fibrosis of the small airways (bronchiolitis obliteration), especially in lung transplantation (LTx). Although survival after LTx has improved over time, it is, with a 5-year survival rate of only 50 to 60%, still significantly worse than that of other organ transplants. It is likely that bronchial arterial revascularisation at the time of LTx plays an important transplant-preserving function.


Assuntos
Artérias Brônquicas , Transplante de Pulmão , Brônquios/cirurgia , Artérias Brônquicas/diagnóstico por imagem , Artérias Brônquicas/cirurgia , Humanos , Pulmão , Transplante de Pulmão/efeitos adversos , Perfusão
18.
Heart Vessels ; 37(12): 2101-2106, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35729428

RESUMO

Hemoptysis is a common clinical emergency, bronchial arterial embolization is considered to be an effective treatment. The presence of coronary artery-bronchial artery fistula (CBF) may lead to recurrence of hemoptysis after treatment. It is necessary to investigate the imaging characteristics of a CBF and its correlation with the severity of pulmonary disease. With the development of multi-detector computed tomography, our study used the 320-slice CT bronchial artery angiography technology to observe and visualize blood vessels. The image and clinical data of 2015 hemoptysis patients with 320-slice CT bronchial artery angiography were retrospectively reviewed from January 2015 to December 2019. The axial and three-dimensional CT images were analyzed. The incidence, anatomical characteristics of CBF and pulmonary disease severity score were evaluated. A total of 12 CBF vessels were detected in 11 patients. We found that the incidence of CBF in this group was 0.55% (11/2015). Mean CBF diameter was 1.9 mm (1.2-2.5 mm). The course of CBF usually was relatively fixed. The proportions of CBF originated from the left circumflex artery, right coronary artery, and left anterior descending artery were 75%, 16.7% and 8.3%, respectively. Preliminarily analysis of the correlation between the trend of CBF and the pulmonary diseases severity score showed that CBF was more likely to communicate with a bronchial artery on the side with a higher severity score. CBF may occur in patients with chronic pulmonary disease and hemoptysis, and its origin, course and trend are characteristic. Detailed and comprehensive computed tomography angiography image analysis is helpful to improve the clinical treatment of hemoptysis with CBF.


Assuntos
Embolização Terapêutica , Fístula , Pneumopatias , Humanos , Artérias Brônquicas/diagnóstico por imagem , Hemoptise/diagnóstico , Hemoptise/etiologia , Hemoptise/terapia , Vasos Coronários/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada Multidetectores , Pneumopatias/complicações , Pneumopatias/terapia , Fístula/complicações , Fístula/terapia , Artéria Pulmonar/diagnóstico por imagem
19.
J Cyst Fibros ; 21(6): 1042-1047, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35508453

RESUMO

LABELLED BACKGROUND: Haemoptysis is a life-threatening complication of cystic fibrosis (CF). One treatment is bronchial artery embolisation (BAE) using embolic-microspheres (EMs). During BAE, pulmonary arteries can be seen on digital subtracted angiography while iodine containing contrast material injection is performed in the bronchial artery. This suggests that EMs could go from bronchial to nontarget pulmonary arteries. The aim was to evaluate if EMs could be found inside pulmonary arteries on lung explants after BAE in transplanted CF patients. METHODS: Retrospective observational study including patients with CF who underwent lung transplantation and had previously needed BAE. Clinical, chest CT angiography, and angiographic data were reviewed from medical records. Pathology examination of lung explants was performed to analyze the EMs anatomical localisation. RESULTS: Eight patients were included between 2013 and 2015, four males with a mean age of 29 (19-45) years. All patients had bronchial artery hypertrophy on CT and bronchial-to-pulmonary artery shunting during BAE. On pathology examination, EM ≤800 µm were found in the pulmonary arteries in all patients and were responsible for distal branch occlusions. Two pulmonary infarcts were observed on CT angiography after BAE and confirmed histopathologically. CONCLUSIONS: EM migration from the bronchial to pulmonary arteries is a common occurrence after BAE in patients with advanced stage CF. Although BAE is a highly effective means of controlling haemoptysis in CF, studies on the optimal particle size are needed to preserve pulmonary artery circulation, because these results suggest that low size EMs could lead to nontarget embolisation.


Assuntos
Fibrose Cística , Embolização Terapêutica , Masculino , Humanos , Adulto , Artérias Brônquicas/diagnóstico por imagem , Hemoptise/diagnóstico , Hemoptise/etiologia , Hemoptise/terapia , Fibrose Cística/complicações , Fibrose Cística/terapia , Embolização Terapêutica/efeitos adversos , Angiografia/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento
20.
Sci Rep ; 12(1): 6906, 2022 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-35484185

RESUMO

Because of its extremely rare incidence, the safety and efficacy of bronchial artery embolization (BAE) for the treatment of hemoptysis caused by pulmonary metastasis from HCC are not well known. We therefore evaluated the safety and efficacy of BAE in these patients. Data from 18 patients with hepatocellular carcinoma (HCC) and pulmonary metastasis who received BAE for the treatment of hemoptysis between 2003 and 2021 were retrospectively reviewed. Technical and clinical success were achieved in 100% and 94% of patients, respectively. Of the 18 embolization procedures, six were performed using polyvinyl alcohol (PVA) particles only, five were performed using gelfoam only, three were performed using gelfoam plus microcoils, one was performed using PVA plus microcoils, one was performed using embospheres, one was performed using lipiodol plus PVA and gelfoam, and one was performed using hystoacryl with microballoon protection. In eight patients for whom CT just before BAE and at follow-up were available, the mean size of the largest metastatic tumor decreased from 5.1 to 3.7 cm (P = 0.035). Hemoptysis recurred in three patients (17%) during follow-up. The median overall and hemoptysis-free survival periods were 149 days and 132 days, respectively. BAE is an effective and safe option for the treatment of hemoptysis in patients with pulmonary metastasis from HCC, with a favorable clinical success rate and a low rate of hemoptysis recurrence. In addition, we also observed BAE to have a positive antitumor effect on pulmonary metastases from HCC, but this requires confirmation in a future study.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Neoplasias Pulmonares , Artérias Brônquicas , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/terapia , Hemoptise/tratamento farmacológico , Hemoptise/terapia , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/terapia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/terapia , Recidiva Local de Neoplasia/tratamento farmacológico , Álcool de Polivinil/uso terapêutico , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...