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Bronchial Artery Embolization for Hemoptysis in Primary Lung Cancer: A Retrospective Review of 84 Patients

Authors
 Kichang Han  ;  Ki Woong Yoon  ;  Jin Hyoung Kim  ;  Gyoung Min Kim 
Citation
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.30(3) : 428-434, 2019 
Journal Title
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 1051-0443 
Issue Date
2019
MeSH
Aged ; Bronchial Arteries* ; Carcinoma, Non-Small-Cell Lung/complications* ; Carcinoma, Non-Small-Cell Lung/diagnostic imaging ; Carcinoma, Non-Small-Cell Lung/pathology ; Embolization, Therapeutic/adverse effects ; Embolization, Therapeutic/methods* ; Female ; Gelatin Sponge, Absorbable/administration & dosage* ; Gelatin Sponge, Absorbable/adverse effects ; Hemoptysis/etiology ; Hemoptysis/therapy* ; Humans ; Lung Neoplasms/complications* ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Neoplasm Staging ; Polyvinyl Alcohol/administration & dosage* ; Polyvinyl Alcohol/adverse effects ; Progression-Free Survival ; Recurrence ; Republic of Korea ; Retrospective Studies ; Small Cell Lung Carcinoma/complications* ; Small Cell Lung Carcinoma/diagnostic imaging ; Small Cell Lung Carcinoma/pathology ; Time Factors ; Tomography, X-Ray Computed
Abstract
PURPOSE: To evaluate the safety and efficacy of bronchial artery embolization (BAE) in patients with primary lung cancer-related hemoptysis and to identify factors associated with hemoptysis-free survival. METHODS: Data from 84 patients with primary lung cancer (non-small cell [n = 74] and small cell [n = 10]) who underwent BAE from 1997 to 2018 for the management of hemoptysis were retrospectively reviewed. Of these, 53 patients had stage IV lung cancer. The hemoptysis volume prior to initial BAE was trivial (blood-tinged sputum) in 21 patients, moderate (< 300 mL per 24 hours) in 34 patients, and massive (> 300 mL per 24 hours) in 29 patients. RESULTS: Technical success, defined as the ability to selectively embolize the abnormal vessel, was achieved in 83 patients (98.8%), and clinical success was achieved in 69 (82.1%) patients. Polyvinyl alcohol particles were used to embolize in 51 patients, gelfoam in 15 patients, and gelfoam plus microcoils in 17 patients. Hemoptysis recurred in 20 patients (23.8%) during follow-up. The median hemoptysis-free survival and overall survival periods were both 61 days. In the clinical-success and clinical-failure groups, the median overall survival period was 99 and 9 days, respectively (P < .001). In multivariable analysis, massive hemoptysis (P = .012) and cavitary lung mass (P = .019) were predictive factors for shortened hemoptysis-free survival. CONCLUSIONS: BAE is a safe and effective approach to control hemoptysis, although the prognosis in primary lung cancer patients presenting with hemoptysis is generally poor. Massive hemoptysis and cavitary lung mass are significant predictors of shortened hemoptysis-free survival.
Full Text
https://www.sciencedirect.com/science/article/pii/S1051044318314441
DOI
10.1016/j.jvir.2018.08.022
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gyoung Min(김경민) ORCID logo https://orcid.org/0000-0001-6768-4396
Han, Ki Chang(한기창) ORCID logo https://orcid.org/0000-0002-9701-9757
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169958
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