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2007

2007 Haemoptysis treated by Bronchial Artery Embolization: A Retrospective Review

Dr Thomas JS Lee
Department of Medicine, Tuen Mun Hospital

Background
The principle clinical application of Bronchial artery embolization (BAE) is for the control of haemoptysis of various aetiologies, especially massive haemoptysis. However, the medium to long term outcomes of this therapeutic procedure is unknown.

Objective
To evaluate and characterize the predictors of the clinical outcomes, including mortality, of patients who underwent BAE.

Methods
This is a retrospective review of all consecutive patients who underwent BAE from April 1999 to December 2006 in a general public hospital. The demographic characteristics and clinical outcomes were retrieved from case records.

Results
Thirty four patients were identified during the study period with haemoptysis requiring BAE. The follow-up period ranged from 2 to 69 months. Eight patients (23.5%) died (3 due to early and 2 due to late recurrence of massive haemoptysis; 3 patients died from other causes) during the period of follow-up. Eleven patients (32.3%) suffered from recurrent haemoptysis, 5 of these (14.7%) were managed with medical therapy, 5 (14.7%) required repeat BAE, while 1 died while attempting BAE. Factors that were significantly associated with mortality include: the volume of haemoptysis (p=0.031), the need for blood transfusion (p=0.004), abnormal clotting profile (p=0.003), the number of co-morbidities (p=0.024), and recurrent haemoptysis (p=0.048). No clinical characteristic was identified to be associated with recurrent haemoptysis. The originally bleeding vessels were the commonest culprit leading to recurrent haemoptysis requiring repeat embolization.

Conclusion
The medium to long term mortality of haemoptysis patient requiring bronchial artery embolization is high. Factors that may predict mortality include severity of haemoptysis, coagulopathy, co-morbidities, and recurrent haemoptysis.

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