Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study
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 ra...
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BMJ Publishing Group
2017-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/7/2/e014805.full |
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| author | Daijiro Kabata Ayumi Shintani Masanori Akira Masahiko Hara Hideo Ishikawa Misaki Ryuge Jun Takafuji Mihoko Youmoto Yukio Nagasaka Kouji Yamamoto |
| author_facet | Daijiro Kabata Ayumi Shintani Masanori Akira Masahiko Hara Hideo Ishikawa Misaki Ryuge Jun Takafuji Mihoko Youmoto Yukio Nagasaka Kouji Yamamoto |
| author_sort | Daijiro Kabata |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-562a02c92af94608bc3f14cc44da96dd |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2017-02-01 |
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| series | BMJ Open |
| spelling | doaj-art-562a02c92af94608bc3f14cc44da96dd2025-02-09T12:05:09ZengBMJ Publishing GroupBMJ Open2044-60552017-02-017210.1136/bmjopen-2016-014805Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational studyDaijiro Kabata0Ayumi Shintani1Masanori Akira2Masahiko Hara3Hideo Ishikawa4Misaki Ryuge5Jun Takafuji6Mihoko Youmoto7Yukio Nagasaka8Kouji Yamamoto92Department of Clinical Epidemiology and Biostatics, Osaka University Graduate School of Medicine, Suita, JapanDepartment of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, JapanClinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City, Japan2Department of Clinical Epidemiology and Biostatics, Osaka University Graduate School of Medicine, Suita, Japan1Hemoptysis and Pulmonary-Circulation Center, Kishiwada Eishinkai Hospital, Kishiwada, Japan1Hemoptysis and Pulmonary-Circulation Center, Kishiwada Eishinkai Hospital, Kishiwada, Japan1Hemoptysis and Pulmonary-Circulation Center, Kishiwada Eishinkai Hospital, Kishiwada, Japan1Hemoptysis and Pulmonary-Circulation Center, Kishiwada Eishinkai Hospital, Kishiwada, JapanKyoto Respiratory Center, Rakuwakai Otowa Hospital, Kyoto, Japan2Yokohama City University, Biostatistics, Kanagawa, JapanObjectives 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.https://bmjopen.bmj.com/content/7/2/e014805.full |
| spellingShingle | Daijiro Kabata Ayumi Shintani Masanori Akira Masahiko Hara Hideo Ishikawa Misaki Ryuge Jun Takafuji Mihoko Youmoto Yukio Nagasaka Kouji Yamamoto Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study BMJ Open |
| title | Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study |
| title_full | Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study |
| title_fullStr | Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study |
| title_full_unstemmed | Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study |
| title_short | Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study |
| title_sort | efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis a single centre retrospective observational study |
| url | https://bmjopen.bmj.com/content/7/2/e014805.full |
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