| 1. Jones R, Charlton J, Latinovic R, Gulliford MC. Alarm symptoms and identification of non-cancer diagnoses in primary care: cohort study. BMJ. 339:b3094, 2009 Aug 13. |
Review/Other-Dx |
923 605 patients |
To evaluate the predictive value of alarm symptoms for specified non-cancer diagnoses and cancer diagnoses in primary care. |
We analysed data on first episodes of haematuria (11 108), haemoptysis (4812), dysphagia (5999), or rectal bleeding (15 289). Non-cancer diagnoses were common in patients who presented with alarm symptoms. The proportion diagnosed with either cancer or non-cancer diagnoses generally increased with age. In patients presenting with haematuria, the proportions diagnosed with either cancer or non-cancer diagnoses within 90 days were 17.5% (95% confidence interval 16.4% to 18.6%) in women and 18.3% (17.4% to 19.3%) in men. For the other symptoms the proportions were 25.7% (23.8% to 27.8%) and 24% (22.5% to 25.6%) for haemoptysis, 17.2% (16% to 18.5%) and 22.6% (21% to 24.3%) for dysphagia, and 14.5% (13.7% to 15.3%) and 16.7% (15.8% to 17.5%) for rectal bleeding. |
4 |
| 2. Abdulmalak C, Cottenet J, Beltramo G, et al. Haemoptysis in adults: a 5-year study using the French nationwide hospital administrative database. Eur Respir J. 46(2):503-11, 2015 Aug. |
Review/Other-Dx |
15 000 patients |
To define the aetiologies, outcomes and associations with lung cancer in the entire population of a high-income country. |
The main aetiologies were respiratory infections (22%), lung cancer (17.4%), bronchiectasis (6.8%), pulmonary oedema (4.2%), anticoagulants (3.5%), tuberculosis (2.7%), pulmonary embolism (2.6%) and aspergillosis (1.1%). Among incident cases, the 3-year recurrence rate was 16.3%. Of the initial cryptogenic haemoptysis patients, 4% were diagnosed with lung cancer within 3 years. Mortality rates during the first stay and at 1 and 3 years were 9.2%, 21.6% and 27%, respectively.This is the first epidemiological study analysing haemoptysis and its outcomes in an entire population. Haemoptysis is a life-threatening symptom unveiling potentially life-threatening underlying conditions. |
4 |
| 3. Fartoukh M, Khalil A, Louis L, et al. An integrated approach to diagnosis and management of severe haemoptysis in patients admitted to the intensive care unit: a case series from a referral centre. Respir Res. 8:11, 2007 Feb 15. |
Review/Other-Dx |
148 Patients |
To describe the clinical spectrum and outcome of haemoptysis in this setting, and better define the indications for bronchial artery embolisation (BAE). |
Patients (148 males) were aged 51 (+/- sd, 16) years, with a median cumulated amount of bleeding averaging 200 ml on admission. Bronchiectasis, lung cancer, tuberculosis and mycetoma were the main underlying causes. In 21 patients (11%), no cause was identified. A first-line bronchial arteriography was attempted in 147 patients (75%), whereas 46 (23%) received conservative treatment. Patients who underwent BAE had a higher respiratory rate, greater amount of bleeding, persistent bloody sputum and/or evidence of active bleeding on fiberoptic bronchoscopy. When completed (n = 131/147), BAE controlled haemoptysis in 80% of patients, both in the short and long (> 30 days) terms. Surgery was mostly performed when bronchial arteriography had failed and/or bleeding recurred early after completed BAE. Bleeding was controlled by conservative measures alone in 44 patients. The ICU mortality rate was low (4%). |
4 |
| 4. Tom LM, Palevsky HI, Holsclaw DS, et al. Recurrent Bleeding, Survival, and Longitudinal Pulmonary Function following Bronchial Artery Embolization for Hemoptysis in a U.S. Adult Population. J Vasc Interv Radiol. 26(12):1806-13.e1, 2015 Dec. |
Review/Other-Dx |
69 patients |
To report outcomes of bronchial artery embolization (BAE) for hemoptysis, including recurrent bleeding, survival, and longitudinal pulmonary function. |
The technical success rate of BAE was 90%. Clinical success rates at 24 hours and 30 days were 82% and 68%, respectively. Thirty percent of patients had recurrent bleeding that required bronchoscopy (7%) or additional embolization (23%). Median time to recurrent bleeding was 29 days among the 13 patients with sarcoidosis, compared with 293 days among patients without sarcoidosis (P = .0013). The hazard ratio for death in patients with sarcoidosis compared with those without sarcoidosis was 4 (95% confidence interval, 2.6-14.6). Analyzing all instances of pulmonary function tests, slopes of decline in FEV1 and FVC were significantly different (FEV1, P = .0048; FVC, P < .0001) before and after index BAE, with an improvement after BAE (FEV1, 0.8%/y; FVC, 1%/y) and a decrease before BAE (FEV1, -1.6%/y; FVC, -1.4%/y). |
4 |
| 5. Panda A, Bhalla AS, Goyal A. Bronchial artery embolization in hemoptysis: a systematic review. [Review]. Diagnostic & Interventional Radiology. 23(4):307-317, 2017 Jul-Aug. |
Meta-analysis |
50 patients (22 studies) |
To review the role of bronchial artery embolization (BAE) in hemoptysis. |
Overall immediate clinical success rate of BAE, defined as complete cessation of hemoptysis, varied from 70%–99%. However, recurrence rate remains high, ranging from 10%–57%, due to incomplete initial embolization, recanalization of previously embolized arteries, and recruitment of new collaterals. Presence of nonbronchial systemic collaterals, bronchopulmonary shunting, aspergillomas, reactivation TB, and multidrug resistant TB were associated with significantly higher recurrence rates (P < 0.05). Rate of major complications remained negligible and stable over time with median incidence of 0.1% (0%–6.6%). Despite high hemoptysis recurrence rates, BAE continues to be the first-line, minimally invasive treatment of hemoptysis in emergency settings, surgically unfit patients, or in patients with diffuse or bilateral lung disease. |
Not Assessed |
| 6. Sakr L, Dutau H. Massive hemoptysis: an update on the role of bronchoscopy in diagnosis and management. [Review]. Respiration. 80(1):38-58, 2010. |
Review/Other-Tx |
N/A |
To review the literature with regard to the definition, etiology, epidemiology, pathophysiology, diagnosis and treatment of massive hemoptysis, with special emphasis on the role of bronchoscopy as a diagnostic and therapeutic tool. |
The authors present the circumstances under which the use of rigid bronchoscopy should be preferred for controlling massive bleeding and also address the crucial importance of multidisciplinary collaboration by illustrating the roles of endovascular therapy and surgery in the optimal management of massive hemoptysis. |
4 |
| 7. Uzun O, Atasoy Y, Findik S, Atici AG, Erkan L. A prospective evaluation of hemoptysis cases in a tertiary referral hospital. The clinical respiratory journal. 4(3):131-8, 2010 Jul. |
Observational-Dx |
178 patients |
To evaluate the relative frequency of the different causes of hemoptysis, the change of the frequency of diseases, the value of the evaluation process and the outcome in a tertiary referral hospital. |
A total of 178 patients (136 male, 42 female) were included to the study. Lung cancer (51), pulmonary embolism (23) and bronchiectasis (23) constituted most of the diagnosis. The most frequent cause of hemoptysis in males was by far lung carcinoma (50). Twelve cases of bronchiectasis and 11 cases of pulmonary embolism were observed in females. While lung cancer and pulmonary embolism were associated with mild to moderate amounts of bleeding (84% and 100%, respectively), patients with active tuberculosis and pulmonary vasculitis had severe to massive hemoptysis (50% and 44%, respectively). Transthoracic and other organ biopsies, spiral computed tomography (CT) angiography (X pres/GX model TSX-002a, Toshiba, Tochigi Ken, Japan) and aortography yielded high diagnostic results in our group (100%, 67%, 59% and 100%, respectively). The most frequent final diagnosis in patients with normal chest radiograph was pulmonary embolism (seven cases). |
2 |
| 8. Kervancioglu S, Bayram N, Gelebek Yilmaz F, Sanli M, Sirikci A. Radiological findings and outcomes of bronchial artery embolization in cryptogenic hemoptysis. J Korean Med Sci. 30(5):591-7, 2015 May. |
Observational-Dx |
178 patients (26 patients with cryptogenic hemoptysis and 152 patients) |
To investigate the radiologic findings and bronchial artery embolization outcomes in cryptogenic hemoptysis, and to compare the results with non-cryptogenic hemoptysis |
No results stated in the abstract |
2 |
| 9. Ibrahim WH.. Massive haemoptysis: the definition should be revised. European Respiratory Journal. 32(4):1131-2, 2008 Oct. |
Review/Other-Dx |
N/A |
To review the definition of massive hemoptysis. |
No results stated in the abstract. |
4 |
| 10. Lee MK, Kim SH, Yong SJ, et al. Moderate hemoptysis: recurrent hemoptysis and mortality according to bronchial artery embolization. Clin Respir J. 9(1):53-64, 2015 Jan. |
Review/Other-Dx |
852 subjects |
To analyze the prognosis and severity of bleeding on flexible bronchoscopy (FB) between moderate and massive hemoptysis. |
In subjective hemoptysis, recurrent hemoptysis occurred in mild 8.0%, moderate 40.7%, massive hemoptysis 33.8%, and mortality was 4.7%, 13.4% and 13.5%. Especially, no statistical difference was shown in recurrent hemoptysis [hazard ratio (HR)?=?0.795; 95% confidence interval (CI) 0.562-1.125, P?=?0.196] and mortality (HR?=?1.054; 95% CI 0.596-1.864, P?=?0.856) between moderate and massive hemoptysis. In moderate hemoptysis patients, oozing or active bleeding on FB took up 83.3%. In this review, recurrent hemoptysis was more in oozing bleeding than active bleeding (HR?=?1.781; 95% CI 1.214-2.431, P?=?0.002), but mortality was similar (HR?=?1.611; 95% CI 0.930-2.790, P?=?0.089). Recurrent hemoptysis significantly decreased in the group with BAE performed within 24?h (HR?=?0.308; 95% CI 0.149-0.637, P?=?0.001) in moderate hemoptysis. Also, recurrent hemoptysis and mortality were significantly increased in the patients with smoking (=40 pack-years), oozing or active bleeding on FB, and hypertension. |
4 |
| 11. American College of Radiology. ACR–NASCI–SIR–SPR Practice Parameter for the Performance and Interpretation of Body Computed Tomography Angiography (CTA). Available at: https://www.acr.org/-/media/ACR/Files/Practice-Parameters/body-cta.pdf. |
Review/Other-Dx |
N/A |
Guidance document to promote the safe and effective use of diagnostic and therapeutic radiology by describing specific training, skills and techniques. |
No abstract available. |
4 |
| 12. Fartoukh M, Khoshnood B, Parrot A, et al. Early prediction of in-hospital mortality of patients with hemoptysis: an approach to defining severe hemoptysis. Respiration. 83(2):106-14, 2012. |
Observational-Dx |
1,087 patients |
To evaluate in-hospital mortality determinants that might be helpful to best characterize severe hemoptysis |
The in-hospital mortality of the 1,087 patients (age 54 years, 71% male) was 6.5% (95% CI 5-8). Chronic alcoholism, cancer or aspergillosis, pulmonary artery involvement, infiltrates involving two quadrants or more on the admission radiograph, and mechanical ventilation at referral predicted independently mortality. The model showed good concordance between predicted and observed probabilities of death and good discrimination (receiver operating characteristic curve area 0.87; 95% CI 0.82-0.92). The model-based score (chronic alcoholism, pulmonary artery involvement, and radiographic patterns, 1 point each; cancer, aspergillosis, and mechanical ventilation, 2 points each) predicted the probability of death as follows: score 0, 1%; score 1, 2%; score 2, 6%; score 3, 16%; score 4, 34%; score 5, 58%; score 6, 79%, and score 7, 91%. |
2 |
| 13. Sopko DR, Smith TP. Bronchial artery embolization for hemoptysis. Semin Intervent Radiol 2011;28:48-62. |
Review/Other-Dx |
N/A |
To summarize the etiologies, pathophysiology, and the diagnostic and management strategies of hemoptysis as related to bronchial artery embolization. In addition, the techniques of arteriography and embolization as well as associated procedural outcomes and complications are delineated. |
No results stated in the abstract. |
4 |
| 14. Pei R, Zhou Y, Wang G, et al. Outcomes of bronchial artery embolization for life-threatening hemoptysis secondary to tuberculosis. PLoS ONE. 9(12):e115956, 2014. |
Observational-Dx |
112 patients |
To appraise the immediate and long-term outcomes of bronchial arterial embolization for life-threatening hemoptysis secondary to tuberculosis. |
The hemoptysis control rate was 86.6% at 14 days, 84.8% at 30 days, 78.6% at 240 days, 75.9% at 360 days, respectively. None of these characteristics, including gender, age and tuberculosis status, was significantly associated with immediate control of bleeding. Patients with active tuberculosis had a significantly longer recurrence-free duration than did patients with inactive tuberculosis (P = 0.040), which was further confirmed by Cox regression hazards model (P = 0.046). There was no spinal cord complication or mortality related to bronchial artery embolization. The most common complication was transient chest pain. |
2 |
| 15. Bhalla A, Kandasamy D, Veedu P, Mohan A, Gamanagatti S. A retrospective analysis of 334 cases of hemoptysis treated by bronchial artery embolization. Oman Medical Journal. 30(2):119-28, 2015 Mar. |
Review/Other-Dx |
334 patients |
To analyze the safety and efficacy of bronchial artery embolization (BAE) in the management of hemoptysis. |
Mild hemoptysis was seen in 70 patients, moderate in 195 patients, and severe in 69 patients. On imaging, right side disease was seen in 101 patients, left side involvement in 59 patients, and bilateral involvement in 174 patients. Post-tubercular changes were the predominant pathology seen in 248 patients. Among 334 patients (386 procedures), 42 patients underwent the procedure twice and five patients underwent the procedure thrice. A total of 485 arteries were attempted of which 440 arteries were successfully embolized. Right intercosto-bronchial was the most common culprit artery present in 157 patients, followed by common bronchial (n=97), left bronchial (n=55), and right bronchial (n=45). We embolized a maximum of four arteries in one session. Immediate complications such as dissection and rupture occurred in only nine sessions (2.3%). Twenty-five procedures (6.5%) were repeated within two months, which were due to technical or clinical failure and 27 procedures (7%) were repeated after two months. |
4 |
| 16. Shao H, Wu J, Wu Q, et al. Bronchial artery embolization for hemoptysis: a retrospective observational study of 344 patients. Chin Med J. 128(1):58-62, 2015 Jan 05. |
Observational-Dx |
344 patients |
To discuss the clinical analysis, embolization approach, outcomes and complications of BAE for the treatment of hemoptysis. |
Three hundred and forty-four consecutive patients underwent bronchial arteriography, 336 of 344 patients (97.7%) performed BAE; there were 1530 coils for 920 arteries embolized; the main responsible sources for bleeding were right bronchial artery (29.7%), left bronchial artery (21.6%), combined right and left bronchial trunk (18.4%), right intercostal arteries (13.3%); 61 patients (17.7%) had recurrent hemoptysis within 1 month after undergoing BAE, 74 patients (21.5%) had recurrent hemoptysis over 1 month after undergoing BAE; The common complications of BAE included subintimal dissection, arterial perforation by a guide wire, fever, chest pain, dyspnea, etc. The follow-up was completed in 248 patients, 28 patients had been dead, 21 patients still bleed, 92 patients had lost to follow-up. |
2 |
| 17. Agmy GM, Wafy SM, Mohamed SAA, Gad YA, Mustafa H, Abd El-Aziz AE-S. Bronchial and Nonbronchial Systemic Artery Embolization in Management of Hemoptysis: Experience with 348 Patients. ISRN Vascular Medicine 2013;2013:1-7. |
Review/Other-Dx |
348 Patients |
To report our experience with bronchial artery embolization (BAE) in the management of moderate recurrent and/or life-threatening hemoptysis. |
Three hundred forty-one patients underwent BAE for the management of moderate recurrent or life-threatening hemoptysis. Pulmonary TB and bronchiectasis were the most common etiologies for hemoptysis in our locality. The most common angiographic signs for hemoptysis were hypervascularity and systemic-pulmonary artery shunt. BAE was successful in controlling hemoptysis immediately in 95% of patients and at 1 month in 90% of patients. Recurrence of hemoptysis was observed in 9.6% of patients, and reembolization was indicated in 85% of those cases. Complications of BAE were self-limited acute and subacute complications, while chronic complications were not recorded during this study. |
4 |
| 18. Woo S, Yoon CJ, Chung JW, et al. Bronchial artery embolization to control hemoptysis: comparison of N-butyl-2-cyanoacrylate and polyvinyl alcohol particles. Radiology. 269(2):594-602, 2013 Nov. |
Observational-Dx |
406 patients |
To retrospectively compare safety and effectiveness of embolic agents polyvinyl alcohol (PVA) particles versus n-butyl-2-cyanoacrylate (NBCA) for bronchial artery embolization (BAE) for control of hemoptysis. |
Technical success was achieved in 93.9% (275 of 293) and 96.5% (109 of 113) of patients for PVA and NBCA, respectively (P = .463); clinical success was achieved in 92.2% (270 of 293) and 96.5% (109 of 113) of patients for PVA and NBCA, respectively (P = .180). Overall and major complication rates were not statistically different (overall complication rates: 34.1% for PVA, 31.0% for NBCA; P = .56; major complication rates: 0.3% for PVA, 0% for NBCA; P > .999). The 1-, 3-, and 5-year hemoptysis-free survival rates were, respectively, 77%, 68%, and 66% for PVA and 88%, 85%, and 83% for NBCA (P = .01). Recanalization of previously embolized vessels was more frequent in PVA group (21.5%) than in NBCA group (1.8%; P < .001). NBCA group showed hemoptysis-free survival rates superior to PVA group in patients with bronchiectasis (P = .016). PVA (P = .050) and aspergilloma (P < .001) were predictive factors for recurrent hemoptysis. |
2 |
| 19. Shin BS, Jeon GS, Lee SA, Park MH. Bronchial artery embolisation for the management of haemoptysis in patients with pulmonary tuberculosis. Int J Tuberc Lung Dis. 15(8):1093-8, 2011 Aug. |
Observational-Dx |
398 patients |
To evaluate immediate and long-term outcomes of bronchial artery embolisation (BAE) for the treatment of haemoptysis in patients with pulmonary tuberculosis (TB), and to clarify factors that influence recurrence. |
Haemoptysis was stopped or markedly decreased, with subsequent clinical improvement, in 163 patients (96.4%); in 50 patients symptoms recurred during the follow-up period. Disease activity, aortography and mycetoma showed a statistically significant correlation with recurrence rate. Cumulative non-recurrence rates were 76.1% for 12 months and 51.4% for 40 months. The median non-recurrence time was 41.2 months. Disease activity and mycetoma showed a statistically significant correlation with early recurrence. Only one major complication was observed. |
2 |
| 20. Mehta AS, Ahmed O, Jilani D, et al. Bronchial artery embolization for malignant hemoptysis: a single institutional experience. Journal of Thoracic Disease. 7(8):1406-13, 2015 Aug. |
Observational-Dx |
26 patients |
To assess the effectiveness of bronchial artery embolization (BAE) in patients with malignant hemoptysis. |
A total of 26 patients (13 male, 13 female) with lung malignancy underwent BAE for hemoptysis from 2003-2013. Histologic analysis revealed 80% (21/26) of cases were from primary lung malignancies, while the remaining 20% (4/26) represented metastatic disease. Sixty-five percent (17/26) of patients underwent bronchoscopy prior to BAE. Follow-up ranged from 2 to 1,909 days, with average of 155 days. Technical success was achieved in 77% of patients (20/26). Clinical success rate was 75% (15/20). Eighty-five percent of embolized patients (17/20) were treated with particles, 15% (3/20) with gelfoam, and 20% (4/20) with coils. Single-vessel embolization was performed in 70% (14/20), two-vessel in 20% (4/20), and multiple vessels in 10% (2/20). No complications were reported. Six-month all-cause mortality of treated cases was 55% (11/20) with an in-hospital mortality of 25% (5/20). Ten percent (2/20) had remote re-bleeding events beyond 6 months. Statistically significant predictors of mortality were intubation status, hemoglobin/hematocrit at presentation, and thrombocytopenia. |
2 |
| 21. Razazi K, Parrot A, Khalil A, et al. Severe haemoptysis in patients with nonsmall cell lung carcinoma. Eur Respir J. 45(3):756-64, 2015 Mar. |
Observational-Dx |
125 patients |
To describe the clinical characteristics, pathophysiology and outcome of NSCLC-related haemoptysis. |
We included 125 consecutive patients with severe haemoptysis (>100 mL) at admission, 65 (52%) exhibiting squamous cell carcinoma. Tumour cavitation/necrosis was reported in 26 (21%) patients. 52 patients had received anticancer treatment, but none had received anti-angiogenic agents. Severe haemoptysis was related mainly to the bronchial artery (82%), and major pulmonary artery involvement was rare (6.4%). Interventional radiology was performed in 102 patients. Bleeding cessation was achieved in 108 (87%) out of 125 patients. The overall in-hospital and 1-year survival rates were 69% and 30%, respectively. Performance status (PS) = 2 (OR 3.6, 95% CI 1.3-9.6), advanced stage (OR 8.6, 95% CI 2-37) and mechanical ventilation (OR 13, 95% CI 4.5-36) were independent predictors of in-hospital mortality. Performance status = 2 (hazard ratio (HR) 2.4, 95% CI 1.5-3.7), advanced stage (HR 4, 95% CI 2.1-7.7), cancer progression (HR 2, 95% CI 1.01-2.7) and cavitation/necrosis (HR 1.7, 95% CI 1.21-3.2) were independently associated with 1-year mortality. Management of severe haemoptysis related to NSCLC should be improved, given our observed survival rates after hospital discharge. |
2 |
| 22. Delage A, Tillie-Leblond I, Cavestri B, Wallaert B, Marquette CH. Cryptogenic hemoptysis in chronic obstructive pulmonary disease: characteristics and outcome. Respiration. 80(5):387-92, 2010. |
Observational-Dx |
39 patients |
To assess the functional characteristics of COPD patients presenting with cryptogenic hemoptysis (CH), the risk factors for CH and the severity of hemoptysis, as well as long-term outcome. |
Twenty-one patients (54%) had at least 1 risk factor for prolonged bleeding. Patients with more severe airflow obstruction tended to have more severe bleeding. Bronchoscopy appeared as useful as a CT in locating the bleeding site. Arterial embolization succeeded in controlling bleeding in all patients who underwent angiography. One patient experienced a relapse in bleeding at 2 months. One developed lung cancer after 1 year. Thirty-four patients were followed for an average of 5 years. Only 2 subjects experienced recurrent hemoptysis. None died. |
3 |
| 23. Sbano H, Mitchell AW, Ind PW, Jackson JE. Peripheral pulmonary artery pseudoaneurysms and massive hemoptysis. AJR Am J Roentgenol. 184(4):1253-9, 2005 Apr. |
Review/Other-Tx |
8 patients with pulmonary artery pseudoaneurysms |
To determine the incidence and etiology of pulmonary artery pseudoaneurysms in patients undergoing bronchial angiography for massive hemoptysis and to assess patient outcome after the embolization of these pseudoaneurysms. |
Peripheral pulmonary artery pseudoaneurysms occur in up to 11% of patients undergoing bronchial angiography for hemoptysis. These are often most easily appreciated on bronchial and/or nonbronchial systemic arterial angiograms because of complete reversal of flow in pulmonary artery branches in the diseased lung. Embolization of bronchial and nonbronchial systemic arteries alone may not be sufficient therapy to control hemoptysis, and occlusion of the pseudoaneurysm itself via a pulmonary artery approach is recommended. |
4 |
| 24. Shin TB, Yoon SK, Lee KN, et al. The role of pulmonary CT angiography and selective pulmonary angiography in endovascular management of pulmonary artery pseudoaneurysms associated with infectious lung diseases. J Vasc Interv Radiol. 18(7):882-7, 2007 Jul. |
Observational-Dx |
10 patients |
To determine the value of performing selective angiography based on the findings of pulmonary computed tomographic (CT) angiography for the detection of a pulmonary artery pseudoaneurysm (PAP) associated with infectious lung diseases and to evaluate the usefulness of endovascular management of these PAPs. |
The findings of main pulmonary angiography were contrast agent filling of the pseudoaneurysm (n = 4) and hypoperfusion of the diseased pulmonary segment without contrast agent filling of the pseudoaneurysm (n = 6). The selective angiogram based on pulmonary CT angiography demonstrated five cases of pseudoaneurysm that were not found on the main pulmonary angiogram. Embolization of the pseudoaneurysm was successfully performed in nine of the 10 patients. One patient experienced a rupture of the subsegmental branch of the inferior pulmonary artery during the procedure. |
2 |
| 25. Khalil A, Parrot A, Nedelcu C, Fartoukh M, Marsault C, Carette MF. Severe hemoptysis of pulmonary arterial origin: signs and role of multidetector row CT angiography. Chest. 133(1):212-9, 2008 Jan. |
Review/Other-Dx |
272 patients |
To assess the Multidetector row CT angiography (MDCTA) signs and role in managing hemoptysis of pulmonary arterial origin. |
Of 272 patients who were referred for severe hemoptysis to the RICU, 189 patients were treated by endovascular means. Thirteen patients (nine men, four women; mean age, 45 years) had hemoptysis of pulmonary arterial origin. Signs of pulmonary arterial hemoptysis seen on MDCTA were of the following three types: pseudoaneurysm (n = 5); aneurysm of the pulmonary artery (n = 3); or the presence of a pulmonary artery in the inner wall of a cavity (n = 5). Hypertrophy of the bronchial arteries seen on MDCTA associated with any of these signs predicted the necessity to treat both the bronchial and pulmonary arteries. Pulmonary artery vasoocclusion was performed as a first treatment in eight patients with such an association (n = 1) or without such an association (n = 7) along with bronchial artery embolization. The remaining five patients were treated with systemic artery embolization, followed by surgery (n = 1), pulmonary artery vasoocclusion (n = 3), and death from massive hemoptysis (n = 1). |
4 |
| 26. Shin S, Shin TB, Choi H, et al. Peripheral pulmonary arterial pseudoaneurysms: therapeutic implications of endovascular treatment and angiographic classifications. Radiology. 256(2):656-64, 2010 Aug. |
Review/Other-Tx |
24 patients |
To classify peripheral pulmonary arterial pseudoaneurysms (PAPs) associated with infectious lung diseases according to angiographic findings and to determine treatment options for PAPs on the basis of angiographic classifications. |
For type A or B PAPs, bronchial and nonbronchial systemic collateral arteries and pulmonary arteries were successively embolized. Hemoptysis was controlled for all type A and type B PAPs. For type C or type D PAPs, embolization alone of bronchial and nonbronchial systemic collateral arteries and follow-up pulmonary CT angiography were performed. Hemoptysis was not controlled in three of the nine patients: In those patients, percutaneous injection therapy (n = 2) and surgical resection (n = 1) were performed. |
4 |
| 27. Naidich DP, Funt S, Ettenger NA, Arranda C. Hemoptysis: CT-bronchoscopic correlations in 58 cases. Radiology. 1990; 177(2):357-362. |
Observational-Dx |
58 patients |
To evaluate the CT findings in a series of patients presenting with hemoptysis who subsequently underwent fiberoptic bronchoscopy (FOB). The specific intent was to assess the potential role of CT as a screening modality. |
Abnormalities involving the airways were depicted by CT in 28 cases (48%). In 18 of these (31% of the total group of 58), focal abnormalities involving the central airways were identified (17 were subsequently proved to be malignant) and in 10 (17% of the total), CT showed bronchiectasis. Focal airway abnormality was shown by FOB in 18 cases (31%); all of these were depicted with CT. Malignancy was diagnosed in 24 patients, including three in whom results of FOB were normal but malignant cells were identified at transbronchial biopsy. CT abnormalities were identified in all cases of malignancy. In 10 of 21 cases (48%) of non-small cell lung cancer, CT allowed definitive staging by documenting either direct mediastinal invasion and/or metastatic disease, while FOB allowed definitive staging in only three cases. CT studies provided no false-negative results. |
4 |
| 28. Revel MP, Fournier LS, Hennebicque AS, et al. Can CT replace bronchoscopy in the detection of the site and cause of bleeding in patients with large or massive hemoptysis? AJR Am J Roentgenol. 2002; 179(5):1217-1224. |
Observational-Dx |
80 patients |
To assess the capacity of chest radiography and CT to determine the cause and site of bleeding in patients with either large or massive hemoptysis compared with bronchoscopy. |
Findings on chest radiography were normal in only 13% of patients, of whom 70% had bronchiectasis. The chest radiographs revealed the site of bleeding in 46% of the patients and the cause in 35%, most of whom had tuberculosis or tumors. CT was more efficient than bronchoscopy for identifying the cause of bleeding (77% vs 8%, respectively; p < 0.001), whereas the two methods were comparable for identifying the site of bleeding (70% vs 73%, respectively; p = not significant). |
3 |
| 29. Dabo H, Gomes R, Marinho A, Madureira M, Paquete J, Morgado P. Bronchial artery embolisation in management of hemoptysis--A retrospective analysis in a tertiary university hospital. Rev Port Pneumol (Barc). 22(1):34-8, 2016 Jan-Feb. |
Observational-Dx |
88 patients |
To characterise patients with hemoptysis undergoing bronchial artery angiography (BAA) for embolisation, evaluating outcomes. |
A total of 88 patients were submitted to BAA, 47 (53.4%) were male, with a mean age of 61.4 ± 15.8 years. In 64 (72.7%) patients, hemoptysis presented as chronic recurrent episodes. Hemoptysis was considered severe in 40 (45.5%) patients. Bronchiectasis (other than cystic fibrosis) (n=35; 38.0%) and tuberculosis sequelae (n=31; 35.2) were the major aetiology for hemoptysis. The main angiographic abnormality was hypertrophy and tortuosity (n=68; 77.3%). BAE was performed in 67 (76.1%) of the 88 patients submitted to BAA. Immediate success was achieved in 66 (98.5%) patients. Recurrence of hemoptysis occurred in 25 (37.3%) patients, and was related to presence of shunting (p=0.049). The procedure-related complications were self-limited. |
2 |
| 30. Yoon YC, Lee KS, Jeong YJ, Shin SW, Chung MJ, Kwon OJ. Hemoptysis: bronchial and nonbronchial systemic arteries at 16-detector row CT. Radiology. 234(1):292-8, 2005 Jan. |
Observational-Dx |
22 patients |
To retrospectively evaluate 16-detector row CT compared with conventional angiography in depiction of bronchial and nonbronchial systemic arteries in patients with hemoptysis. |
52 (30 right and 22 left) bronchial arteries and 33 nonbronchial systemic arteries were visible at CT. 34 (20 right and 14 left) of 52 bronchial arteries were traceable from their origins to the hilum. 31 (16 right and 15 left) of 46 (27 right and 19 left) bronchial arteries and 26 of 64 nonbronchial systemic arteries evaluated at angiography were causing hemoptysis. Forty (87%, 23 right and 17 left) of 46 bronchial arteries seen at angiography were also detected at CT. All 31 bronchial arteries and sixteen (62%) of 26 nonbronchial systemic arteries causing hemoptysis were detected at CT. Twenty-three (74%) of 31 bronchial arteries causing hemoptysis were traceable from their origins to the hilum, and one (11%) of nine bronchial arteries not causing hemoptysis was traceable (P = .002). |
3 |
| 31. Seon HJ, Kim YH, Kwon YS. Localization of bleeding sites in patients with hemoptysis based on their chest computed tomography findings: a retrospective cohort study. BMC polm. med.. 16(1):160, 2016 11 25. |
Observational-Dx |
161 patients |
To propose a localization strategy for bleeding sites in hemoptysis patients using their chest computed tomography (CT) findings. |
The concordance rate between the most prominent GGA and FOB findings was higher than that between specific lesions and FOB findings (Kappa value [k]?=?0.751 vs. 0.448, p?<?0.001). Among the specific lesions, there were high concordance rates between lung cancer and FOB findings (3/3, 100%) and fungus balls and FOB findings (8/9, 89%). The agreement of localization of the bleeding site between FOB findings and the localization strategy based on chest CT findings including the most prominent GGA, lung cancer and fungus balls, showed almost perfect (k?=?0.904). |
2 |
| 32. Tsoumakidou M, Chrysofakis G, Tsiligianni I, Maltezakis G, Siafakas NM, Tzanakis N. A prospective analysis of 184 hemoptysis cases: diagnostic impact of chest X-ray, computed tomography, bronchoscopy. Respiration. 73(6):808-14, 2006. |
Observational-Dx |
184 patients |
To evaluate the relative frequency of different causes of hemoptysis and the value of chest radiography, computed tomography (CT) scanning and fiber-optic bronchoscopy in the evaluation of a Greek cohort population. |
The main causes of hemoptysis were bronchiectasis (26%), chronic bronchitis (23%), acute bronchitis (15%) and lung cancer (13%). Bronchiectasis was significantly more frequent in nonsmokers (p < 0.02). Among nonsmokers, patients with moderate/severe bleeding or a history of tuberculosis were more likely to have bronchiectasis (OR 8.25; 95% CI 1.9-35.9, p = 0.007 and OR 16.5; 95% CI 1.7-159.1, p = 0.007, respectively). Nonsmokers with normal or abnormal X-rays were equally likely to have bronchiectasis (OR 2.5; 95% CI 0.66-9.39, p = 0.2). Lung cancer was only found in smokers. Smokers with normal X-rays were less likely to have lung cancer compared to smokers with abnormal X-ray (OR 5.4; 95% CI 1.54-19.34, p = 0.004). There were no smokers with normal CT and lung cancer. Follow-up data were collected in 91% of patients. Lung cancer did not develop in any patient assumed to have hemoptysis of another origin than lung cancer on initial evaluation. |
2 |
| 33. Khalil A, Fartoukh M, Parrot A, Bazelly B, Marsault C, Carette MF. Impact of MDCT angiography on the management of patients with hemoptysis. AJR Am J Roentgenol. 195(3):772-8, 2010 Sep. |
Observational-Dx |
400 patients |
To evaluate the ability of MDCT angiography to modify early results in patients undergoing endovascular embolization for hemoptysis. |
Differences between the groups were statistically significant for patient age (p < 0.05), endovascular treatment failure among patients older than 70 years (p < 0.05), pulmonary artery vasoocclusion in comparison with diagnostic pulmonary artery angiography (p < 0.0001), and urgent surgical resection (p = 0.034). The impact of MDCT angiography was significant in reducing the rate of vascular catheterization failure in patients older than 70 years, increasing the number of pulmonary artery vasoocclusions, and reducing the number of urgent surgical resection. |
3 |
| 34. Remy-Jardin M, Bouaziz N, Dumont P, Brillet PY, Bruzzi J, Remy J. Bronchial and nonbronchial systemic arteries at multi-detector row CT angiography: comparison with conventional angiography. Radiology. 233(3):741-9, 2004 Dec. |
Observational-Dx |
48 patients |
To retrospectively evaluate bronchial and nonbronchial systemic arteries at multi-detector row helical computed tomography (CT) compared with conventional angiography in patients undergoing endovascular treatment of hemoptysis. |
Among the 46 patients initially treated with bronchial artery embolization, 58 bronchial arteries were identified at CT and/or angiography. In 50 (86%) cases, concordant findings were observed with both modalities. In five (9%) cases, CT could not be used to identify the ostia of bronchial arteries. In three (5%) cases, CT depicted bronchial arteries that could not be selectively catheterized. Three-dimensional images were found to be superior to transverse CT scans in depicting the ectopic origin of the bronchial arteries, which enabled the interventional radiologists to perform successful embolization after direct catherization of the ectopic vessel in every case. In five (11%) patients, the nonbronchial systemic origin of bronchial bleeding was identified on CT angiograms. |
2 |
| 35. Hartmann IJ, Remy-Jardin M, Menchini L, Teisseire A, Khalil C, Remy J. Ectopic origin of bronchial arteries: assessment with multidetector helical CT angiography. Eur Radiol. 17(8):1943-53, 2007 Aug. |
Observational-Dx |
214 patients; 77 patients with at least one bronchial artery were studied. |
To determine non-invasively the frequency of ectopic bronchial arteries (BA) (i.e., bronchial arteries originating at a level of the descending aorta other than T5-T6 or from any aortic collateral vessel) on multidetector-row CT angiograms (CTA) obtained in patients with hemoptysis. |
147 ectopic arteries were depicted, originating as common bronchial trunks (n = 23; 19%) or isolated right or left bronchial arteries (n = 101; 81%). The most frequent sites of origin of the 124 ostiums were the concavity of the aortic arch (92/124; 74%), the subclavian artery (13/124; 10.5%) and the descending aorta (10/124; 8.5%). The isolated ectopic bronchial arteries supplied the ipsilateral lung in all but three cases. Bronchial artery embolization was indicated in 26 patients. On the basis of CTA information, (1) bronchial embolization was attempted in 24 patients; it was technically successful in 21 patients (orthotopic BAs: 6 patients; orthotopic and ectopic BAs: 3 patients; ectopic BAs: 12 patients) and failed in 3 patients due to an instable catheterization of the ectopic BAs; the absence of additional bronchial arterial supply and no abnormalities of nonbronchial systemic arteries at CTA avoided additional arteriograms in these 3 patients; (2) owing to the iatrogenic risk of the embolization procedure of ectopic BAs, the surgical ligation of the abnormal vessels was the favored therapeutic option in 2 patients. |
3 |
| 36. Mori H, Ohno Y, Tsuge Y, et al. Use of multidetector row CT to evaluate the need for bronchial arterial embolization in hemoptysis patients. Respiration. 80(1):24-31, 2010. |
Observational-Dx |
41 patients |
To assess the characteristics of Bronchial arteryS (BA) using multidetector row computed tomography (MDCT) and identify BAs requiring embolization (BAE) without BA angiography (BAG). |
MDCT enabled visualization of 102 ostia and 96 traceable BAs. Among the participating patients, 13 had at least one ectopic origin. We obtained a good correlation between BAG and MDCT diameters (r = 0.709, p < 0.001). The diameters of BAs responsible for bleeding and receiving BAE were apparently larger in each measured segment than those that were not (p < 0.05). Moreover, the diameters of arteries receiving BAE remained largely unchanged from the origin to the hilum and through the mediastinum. BAs with low MDCT scores were significantly less likely to required BAE than those with high scores (p = 0.004), and in multiple logistic regression analysis, ostium diameter and bleeding status were independent predictive factors for BAE. |
2 |
| 37. Jiang S, Sun XW, Yu D, Jie B. Endovascular embolization of bronchial artery originating from the upper portion of aortic arch in patients with massive hemoptysis. Cardiovasc Intervent Radiol. 37(1):94-100, 2014 Feb. |
Review/Other-Dx |
818 patients |
To retrospectively review multidetector row computed tomography angiograms and/or Digital subtraction angiograms . |
The ostia of the BAs were located on the superior surface of the AA between the brachiocephalic trunk and left common carotid artery in three patients, the junction of the aorta and medial surface of the left subclavian artery in two, and the posterior wall of the upper portion of the AA in one. The six BAs comprised two common trunks, three single right sides, and one single left side. The targeted vessels were successfully catheterized and embolized by a coaxial microcatheter system using polyvinyl alcohol particles. Other pathologic BAs and nonbronchial systemic arteries also were embolized. Bleeding was immediately controlled in all patients with no recurrence of hemoptysis. No procedure-related complications occurred. |
4 |
| 38. Lin Y, Chen Z, Yang X, et al. Bronchial and non-bronchial systemic arteries: value of multidetector CT angiography in diagnosis and angiographic embolisation feasibility analysis. J Med Imaging Radiat Oncol. 57(6):644-51, 2013 Dec. |
Observational-Dx |
52 patients |
To evaluate the diagnostic performance of multidetector CT angiography (CTA) in depicting bronchial and non-bronchial systemic arteries in patients with haemoptysis and to assess whether this modality helps determine the feasibility of angiographic embolisation. |
Fifty patients were included in the artery-presence-number analysis. In the per-patient analysis, neither CTA (P?=?0.25) nor DSA (P?=?1.00) showed statistical difference in the detection of arteries causing haemoptysis. The sensitivity, specificity, and positive and negative predictive values were 94%, 100%, 100%, and 40%, respectively, for the presence of pathologic arteries evaluated by CTA, and 98%, 100%, 100%, and 67%, respectively, for DSA. On the per-artery basis, CTA correctly identified 97% (107/110). Fifty-two patients were included in the feasibility analysis. The performance of CTA in predicting the feasibility of angiographic embolisation was not statistically different from the treatment performed (P?=?1.00). The sensitivity, specificity, and positive and negative predictive values were 96%, 80%, 98% and 67%, respectively, for CTA. |
2 |
| 39. Lee S, Chan JW, Chan SC, et al. Bronchial artery embolisation can be equally safe and effective in the management of chronic recurrent haemoptysis. HONG KONG MED. J.. 14(1):14-20, 2008 Feb. |
Review/Other-Dx |
70 patients |
To examine the efficacy and safety of bronchial artery embolisation in patients with acute major haemoptysis and those with chronic recurrent haemoptysis. |
Overall immediate control was attained following 99% of the procedures, with a complication rate of 13%; all complications were mild and self-limiting. For the 32 patients (19 having acute major haemoptysis and 13 having chronic recurrent bleeding) with follow-up data available, the overall recurrence rate was 36% (26% in the acute and 47% in chronic group). No statistically significant difference in recurrence probability between the two groups was observed (P=0.24). Presence of active pulmonary tuberculosis was associated with increased risk of recurrence (P=0.005). |
4 |
| 40. Hsiao EI, Kirsch CM, Kagawa FT, Wehner JH, Jensen WA, Baxter RB. Utility of fiberoptic bronchoscopy before bronchial artery embolization for massive hemoptysis. AJR Am J Roentgenol. 177(4):861-7, 2001 Oct. |
Review/Other-Dx |
28 patients |
To investigate the utility of performing fiberoptic bronchoscopy before bronchial artery embolization in patients with massive hemoptysis. |
The clinically determined diagnoses of the patients' symptoms were tuberculous bronchiectasis (n = 14; 50.0%); bronchogenic carcinoma (n = 4; 14.3%); active tuberculosis (n = 2; 7.1%); nontuberculous bronchiectasis (n = 2; 7.1%); active coccidioidomycosis, pancreaticobronchial fistula, arteriovenous malformation, and tetralogy of fallot (n =1 each; 3.6% each); and unknown cause (n = 2; 7.1%). The bleeding site determined through bronchoscopy was consistent with that determined through radiographs in 23 patients (82.1%); all had either unilateral disease (n = 15), bilateral disease with unilateral cavities (n = 5), or a preponderance of disease on one side (n = 3). Bronchoscopy was an essential tool in determining the bleeding site in only three patients (10.7%), all of whom had bronchiectasis without localizing features visible on chest radiographs. In the remaining two patients (7.1%), bronchoscopic findings were indeterminate, but radiographs were helpful. |
4 |
| 41. Serasli E, Kalpakidis V, Iatrou K, Tsara V, Siopi D, Christaki P. Percutaneous bronchial artery embolization in the management of massive hemoptysis in chronic lung diseases. Immediate and long-term outcomes. Int Angiol. 27(4):319-28, 2008 Aug. |
Observational-Dx |
20 Patients |
To evaluate the immediate and long-term prognosis of bronchial artery embolization (BAE) for the management of massive hemoptysis in our center. |
Immediate control of bleeding was achieved in all patients. Recurrent cases of hemoptysis were observed in 6/20 patients (30%) within 3 years and 4 of them (66.6%) occurred early in the first 3 months. Recurrent-free time was 9 months (standard error: 4) (95% confidence interval: 0-17). Repeated interventions were required in all early recurrences, due to either recanalization of the occluded arteries or non-bronchial systemic artery supply. Combined use of PVA and coils was proved effective in these cases. No serious complications were observed. |
2 |
| 42. O'Neil KM, Lazarus AA. Hemoptysis. Indications for bronchoscopy. Arch Intern Med. 1991; 151(1):171-174. |
Review/Other-Dx |
119 patients |
To review the records of 119 bronchoscopies performed for hemoptysis in patients with a normal (n = 75) or nonlocalizing (n = 44) chest roentgenogram. |
Bronchogenic carcinoma was identified in 2.5% of the bronchoscopies. Additional neoplasms were found in another 2.5%. The presence of nonlocalizing abnormalities was not associated with an increase in either the rate of bronchogenic carcinoma or in the diagnostic yield (specific anatomic diagnosis or bleeding site identified) at bronchoscopy when compared with patients with normal chest roentgenograms. The factors of male sex, age more than 40 years, and a more than 40 pack-year smoking history appear useful in identifying patients in whom the yield of bronchoscopy is likely to be high. |
4 |
| 43. Poe RH, Israel RH, Marin MG, et al. Utility of fiberoptic bronchoscopy in patients with hemoptysis and a nonlocalizing chest roentgenogram. Chest. 1988; 93(1):70-75. |
Observational-Dx |
196 patients |
To develop predictors that might help to identify the patient with hemoptysis who needs to have fiberoptic bronchoscopy, the authors reviewed their community's experience with this population over a five-year period. |
By univariate and discriminant analyses, the authors found that the three factors of age of 50 years or more, male sex, and smoking of 40 pack-years or more best predicted a diagnosis of malignancy. Bleeding in excess of 30 ml daily was associated with an increase in overall diagnostic yield. The presence of two of the three factors associated with malignancy or bleeding in excess of 30 ml daily (or both) identified 100 percent of the patients with bronchogenic carcinoma and 82 percent of all of the diagnostic fiberoptic bronchoscopic procedures. |
4 |
| 44. Thirumaran M, Sundar R, Sutcliffe IM, Currie DC. Is investigation of patients with haemoptysis and normal chest radiograph justified? Thorax. 2009; 64(10):854-856. |
Observational-Dx |
270 patients |
A group of patients with haemoptysis and normal CXR were analyzed to determine whether further investigations were justified. |
275 episodes of haemoptysis with normal chest radiograph were investigated further in 270 patients (60% males). The median age was 60 years. Twenty-six patients were diagnosed to have respiratory tract malignancies (larynx, 1; trachea, 1; lung, 22; carcinoid, 1; and leiomyoma, 1). Eight (31%) of the 26 patients with respiratory tract malignancy had radical treatment. Fibreoptic bronchoscopy was diagnostic of cancer in 14 (54%) of the 26 patients with malignancy. CT of the thorax was suggestive of cancer in 24 (96%) of the 25 patients with malignancy. |
3 |
| 45. Fujita T, Tanabe M, Moritani K, Matsunaga N, Matsumoto T. Immediate and late outcomes of bronchial and systemic artery embolization for palliative treatment of patients with nonsmall-cell lung cancer having hemoptysis. Am J Hosp Palliat Care. 31(6):602-7, 2014 Sep. |
Observational-Dx |
28 patients |
To evaluate immediate outcomes and late outcomes of bronchial artery embolization (BAE) for palliative treatment in patients |
Success rate was 96%. Immediate clinical success within 24 hours after BAE was achieved in 22 of the 27 patients who underwent embolization |
4 |
| 46. Dave BR, Sharma A, Kalva SP, Wicky S. Nine-year single-center experience with transcatheter arterial embolization for hemoptysis: medium-term outcomes. Vasc Endovascular Surg. 2011; 45(3):258-268. |
Observational-Tx |
128 TAE performed in 58 patients |
To determine the medium-term efficacy of transcatheter arterial embolization (TAE) for hemoptysis. |
Technical and clinical successes were estimated at 58 (100%) of 58 and 57 (98%) of 58, respectively. Recurrent hemoptysis occurred in 40% (23 of 58). In all, 34% (20 of 58) died during follow-up. Kaplan-Meier estimates for primary and secondary efficacy of TAE at 2, 4, 6, and 8 years were 0.82, 0.46, 0.17, and 0.09 (benign disease) and 0.30, 0, 0, and 0 (malignant disease), respectively. |
3 |
| 47. Ishikawa H, Hara M, Ryuge M, et al. Efficacy and safety of super selective bronchial artery coil embolisation for haemoptysis: a single-centre retrospective observational study. BMJ Open. 7(2):e014805, 2017 Feb 17. |
Observational-Dx |
489 patients |
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. |
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). |
2 |
| 48. Ando T, Kawashima M, Masuda K, et al. Clinical and Angiographic Characteristics of 35 Patients With Cryptogenic Hemoptysis. Chest. 152(5):1008-1014, 2017 Nov. |
Review/Other-Dx |
35 patients |
To review medical records of 35 patients admitted to our hospital with cryptogenic hemoptysis from October 2010 to September 2014. |
In the 35 cases, bronchial artery embolization was successfully performed in 33 patients (94.3%), whereas bronchoscopic hemostatic therapy was added in one patient (2.8%), and embolization was not performed in one patient (2.8%) because the bronchial artery was too narrow. In the successful embolization group, the non-rebleeding rate was 97.0% for 20 months. The angiographic findings revealed that the diameter of the bronchial arteries was < 2 mm in 13 patients, 2 to 3 mm in 17 patients, and > 3 mm in five patients. Hypervascularization was detected in 29 patients (82.9%) and small bronchial aneurysms in eight patients (22.9%). The amount of hemoptysis was slight (< 50 mL/d) in 12, mild (50-100 mL/d) in 11, moderate (100-200 mL/d) in eight, and massive (> 200 mL/d) in four patients. No obvious relationship was found between the diameter of bronchial arteries and the amount of hemoptysis. |
4 |
| 49. Lee BR, Yu JY, Ban HJ, et al. Analysis of patients with hemoptysis in a tertiary referral hospital. Tuberc Respir Dis (Seoul). 73(2):107-14, 2012 Aug. |
Review/Other-Dx |
221 patients |
To investigate the main causes of hemoptysis, the type of examinations used for diagnosis, the treatment modalities and outcomes. |
Bronchiectasis (32.6%), active pulmonary tuberculosis (18.5%), fungus ball (10.8%), and lung cancer (5.9%) accounted for most causes of hemoptysis. Computed tomography scan was the most sensitive diagnostic test when employed alone, with positive yield of 93.2%. There were 161 cases of conservative treatment (72.9%), 42 cases of bronchial artery embolization (BAE) (19.0%), and 18 cases of surgery (8.1%). Regarding the amount of hemoptysis, 70 cases, out of 221 cases, were mild (31.5%), 36 cases moderate (16.2%), and 115 cases massive hemoptysis (52.0%). Most of the patients were treated conservatively, but if there was more bleeding present, BAE or surgery was more commonly performed than the conservative treatment (p=0.0001). In the multivariate model, severe hemoptysis and lung cancer were independently associated with short-term recurrence. BAE was independently associated with long-term recurrence, and lung cancer was associated with in-hospital mortality. The overall in-hospital mortality rate was 11.3%. |
4 |
| 50. Racil H, Rajhi H, Ben Naceur R, Chabbou A, Bouecha H, Mnif N. Endovascular treatment of haemoptysis: medium and long-term assessment. Diagn Interv Imaging. 94(1):38-44, 2013 Jan. |
Observational-Dx |
53 patients |
To assess the short, medium and long-term results of bronchial artery embolisation (BAE) and identify the factors favouring the recurrence of haemoptysis. |
The aetiologies of haemoptysis were dominated by the residual signs of pulmonary tuberculosis: 18 cases (33.96%), bronchial dilations: 12 cases (22.64%) and aspergilloma: five cases (9.43%). The bronchial arteriography showed signs of bronchial hypervascularisation in 92.45% of the cases. Forty-six patients had a first embolisation (86.79%) with immediate efficacy in 84.90% of the cases (n=45). This efficacy was noted after more than 3 years in 60.08% of the cases. Short (< 30 days) and medium-term (> 30 days and < 3 years) recurrence of haemoptysis were noted in 17.39% and 8.69% of the cases respectively. A statistically significant correlation between aspergilloma and the immediate recurrence was found (P=0.013). The risk of medium and long-term recurrence (> 3 years) was correlated with age. The survival without recurrence was statistically higher when the age was less than 60 years (P=0.0041). |
2 |
| 51. Shin B, Koh WJ, Shin SW, et al. Outcomes of Bronchial Artery Embolization for Life-Threatening Hemoptysis in Patients with Chronic Pulmonary Aspergillosis. PLoS ONE. 11(12):e0168373, 2016. |
Review/Other-Dx |
64 patients |
To retrospectively analyze the clinical data of 64 patients (55 [86%] with CPA and 9 [14%] with SA) who underwent BAE for life-threatening hemoptysis. |
The most common angiographic abnormality was hypervascularity (n = 60, 94%), followed by contrast extravasation (n = 50, 78%) and systemic-pulmonary shunt (n = 48, 75%), with similar incidence rates in both groups. Immediate success was achieved in 41 (64%) BAE procedures, but it was incomplete in 23 (36%) cases due to difficulty with the approach and/or overuse of contrast medium. Clinical failure of BAE was observed in only one (2%) patient. Complications following BAE were observed in four (6%) patients. Recurrence of hemoptysis was seen in a total of 33 patients (52%) within a median of 2.0 (0.3-10.0) months, and repeat BAE was performed in 25 (76%) of these cases. In comparing the outcomes of patients with CPA and SA, there were no differences in the rates of success of initial BAE, incomplete embolization, or clinical failure in the two groups. However, recurrence of hemoptysis tended to be higher in patients with CPA (55%) than in those with SA (33%). In addition, antifungal medications following BAE were more commonly prescribed in the CPA group (56%) compared to the SA group (0%). |
4 |
| 52. Yoo DH, Yoon CJ, Kang SG, Burke CT, Lee JH, Lee CT. Bronchial and nonbronchial systemic artery embolization in patients with major hemoptysis: safety and efficacy of N-butyl cyanoacrylate. AJR Am J Roentgenol. 196(2):W199-204, 2011 Feb. |
Observational-Tx |
108 patients |
To evaluate the safety and efficacy of N-butyl cyanoacrylate for bronchial and nonbronchial systemic artery embolization in the management of major hemoptysis. |
Immediate success was achieved in 105 patients (97.2%). During the follow-up period (range, 5 days-63 months; median, 28.5 months), recurrent hemoptysis was found in 21 of the 105 patients (20%). Repeat angiograms (n = 14) revealed incomplete embolization during the initial procedure in seven patients with early recurrence (< 3 months) and revascularization of nonbronchial systemic collateral arteries in seven patients with late recurrence (> 3 months). No recanalization of embolized arteries was found on repeat angiograms or at follow-up CT. The cumulative nonrecurrence rates were 91.4% 1 month, 83.4% 1 year, 76.7% 3 years, and 56.8% 5 years after the initial procedure. The procedure-related complications included transient chest pain (n = 21) and denudation of the bronchial mucosa (n = 3), which was clinically silent but found at bronchoscopy. |
2 |
| 53. Hwang HG, Lee HS, Choi JS, Seo KH, Kim YH, Na JO. Risk factors influencing rebleeding after bronchial artery embolization on the management of hemoptysis associated with pulmonary tuberculosis. Tuberc Respir Dis (Seoul). 74(3):111-9, 2013 Mar. |
Observational-Dx |
72 patients |
To identify the risk factors contributing to rebleeding after bronchial artery embolization (BAE) in patients with tuberculosis (TB). |
The overall immediate success rate of BAE was 93.1% (67 of 72 patients). Of the 29 patients (40.3%) who showed rebleeding after BAE, 13 patients experienced rebleeding within 1 month, and 14 patients between 1 month to 1 year. The existence of a shunt in angiographic finding, aspergilloma, and diabetes mellitus were risk factors of rebleeding after BAE in multivariate analysis. |
2 |
| 54. Kim SW, Lee SJ, Ryu YJ, et al. Prognosis and Predictors of Rebleeding After Bronchial Artery Embolization in Patients with Active or Inactive Pulmonary Tuberculosis. Lung. 193(4):575-81, 2015 Aug. |
Observational-Dx |
190 patients |
To characterize the prognosis and identify factors that contribute to rebleeding after bronchial artery embolization (BAE) in patients with active or inactive pulmonary tuberculosis (PTB). |
The median age at the time of diagnosis of PTB was 37 years and 54 years at the time of first episode of hemoptysis. Among 47 patients (24.7 %) who experienced rebleeding after BAE during the median follow-up period of 13.9 months [interquartile range (IQR) 2.3-36.0 months], bleeding recurred in 12 patients (6.3 %) within 1 month and in 15 patients (7.9 %) after 1 year. The median non-recurrence time was 8.6 months (IQR 1.2-27.6 months). Independent predictors of rebleeding after BAE were tuberculous-destroyed lung [hazard ratio (HR) 3.0; 95 % confidence interval (CI) 1.5-6.2; p = 0.003], the use of anticoagulant agents and/or antiplatelet agents (HR 2.6; 95 % CI 1.1-5.8; p = 0.022), underlying chronic liver disease (HR 2.7; 95 % CI 1.1-4-6.9; p = 0.033), elevated pre-BAE C-reactive protein (CRP) (mg/dL) (HR 2.4; 95 % CI 1.0-5.5; p = 0.048), and the existence of fungal ball (HR 2.1; 95 % CI 1.0-4.3; p = 0.050). |
2 |
| 55. Okuda K, Masuda K, Kawashima M, et al. Bronchial artery embolization to control hemoptysis in patients with Mycobacterium avium complex. Respir Investig. 54(1):50-8, 2016 Jan. |
Review/Other-Dx |
43 patients |
To evaluate the efficacy and safety of Bronchial artery embolization (BAE) for controlling hemoptysis in MAC patients, and identified the risk factors of rebleeding after BAE. |
Among the 43 patients enrolled in the study, rebleeding developed in 13 cases (30.2%) with a mean follow-up period of 18 months. Median rebleeding-free time after BAE was 29.9 months and the cumulative hemoptysis control rates were 79.1%, 73.8%, and 63.3% in one, two, and three years, respectively. Rebleeding-free time significantly correlated with comorbid chronic pulmonary aspergillosis (CPA). When limited to 35 MAC patients without CPA, the rate increased to 88.6%, 82.1%, and 70.4%, respectively. Factors such as coexisting CPA, multiple embolized vessels at BAE, longer length of time from the diagnosis of MAC to BAE, and an administration of antibiotics for MAC at the time of hemoptysis, indicated statistically significant correlations with rebleeding. Major complications concerning BAE were not encountered. |
4 |
| 56. Garcia-Olive I, Sanz-Santos J, Centeno C, et al. Results of bronchial artery embolization for the treatment of hemoptysis caused by neoplasm. J Vasc Interv Radiol. 25(2):221-8, 2014 Feb. |
Observational-Dx |
40 patients |
To describe experience with bronchial artery embolization (BAE) in a cohort of patients with cancer. |
Immediate control of bleeding was achieved in 31 of 40 patients (77.5%). Recurrence requiring BAE occurred in eight patients (20%). Cumulative hemoptysis control rate was 0.90 (95% confidence interval [CI], 0.80-1.0) at 1 month and 0.65 (95% CI, 0.44-0.86) at 6 months. Probability of survival was 0.75 (95% CI, 0.62-0.88) at 1 month, 0.42 (95% CI, 0.27-0.57) at 6 months, 0.36 (95% CI, 0.21-0.51) at 12 months, and 0.08 (95% CI, 0.0-0.18) at 3 years. |
2 |
| 57. Wang GR, Ensor JE, Gupta S, Hicks ME, Tam AL. Bronchial artery embolization for the management of hemoptysis in oncology patients: utility and prognostic factors. J Vasc Interv Radiol. 20(6):722-9, 2009 Jun. |
Observational-Dx |
30 patients |
To evaluate the utility of bronchial artery embolization (BAE) in the oncology population and determine prognostic factors. |
The amount of hemoptysis at initial embolization was massive (frank blood >300 mL per 24 hours) in 13 patients (43%), moderate (frank blood <300 mL per 24 hours) in 15 (50%), and trivial (blood-tinged sputum) in two (7%). Eighteen patients (60%) had a primary intrathoracic malignancy, seven (23%) had pulmonary metastases, and five (17%) had no evidence of malignant disease in the lung. The technical success rate, defined as the ability to selectively embolize the abnormal vessel, was 86% (32 of 37 procedures). Clinical response categories and complications were defined according to the guidelines established by the SIR Standards of Practice Committee. The major complication rate was 3%, including one case of spinal cord infarction. BAE provided symptom palliation with an immediate decrease or resolution of bleeding in 24 out of 27 patients (89%). The 30-day mortality rate for this cohort was 30%, and the median survival was 5.5 months. Survival was significantly better in patients with non-tumor-related hemoptysis than in those with tumor-related bleeding (P = .004). There was no significant difference in median survival between patients with massive hemoptysis and those with moderate/mild hemoptysis (P = .81), between patients with an emergent procedure and those with a non-emergent procedure (P = .39), and between patients who had previously undergone radiation therapy and those who had not (P = .4). |
2 |
| 58. Garcia-Olive I, Sanz-Santos J, Centeno C, et al. Predictors of recanalization in patients with life-threatening hemoptysis requiring artery embolization. Arch Bronconeumol. 50(2):51-6, 2014 Feb. |
Observational-Dx |
176 patients |
To describe the experience of AE in a tertiary referral center, to characterize angiographic findings at the time of recurrence, and to analyze factors associated with these findings. |
One hundred seventy-six patients were included in the study. Twenty-two patients (12.5%) died due to hemoptysis. Probability of recurrence-free survival at one month was 0.91 (95%CI: 0.87 to 0.95), at 12months was 0.85 (95%CI: 0.79 to 0.91), and after 3 years was 0.75 (95%CI: 0.66 to 0.83). A longer time to recurrence was associated with a higher probability that the hemorrhage affected the same artery (estimate=0.0157, z-value=2.41, p-value=0.016). |
2 |
| 59. Vidal V, Therasse E, Berthiaume Y, et al. Bronchial artery embolization in adults with cystic fibrosis: impact on the clinical course and survival. J Vasc Interv Radiol. 17(6):953-8, 2006 Jun. |
Observational-Dx |
176 patients |
To describe the experience of Artery embolization (AE) in a tertiary referral center, to characterize angiographic findings at the time of recurrence, and to analyze factors associated with these findings. |
One hundred seventy-six patients were included in the study. Twenty-two patients (12.5%) died due to hemoptysis. Probability of recurrence-free survival at one month was 0.91 (95%CI: 0.87 to 0.95), at 12months was 0.85 (95%CI: 0.79 to 0.91), and after 3 years was 0.75 (95%CI: 0.66 to 0.83). A longer time to recurrence was associated with a higher probability that the hemorrhage affected the same artery (estimate=0.0157, z-value=2.41, p-value=0.016). |
2 |
| 60. Flume PA, Mogayzel PJ Jr, Robinson KA, et al. Cystic fibrosis pulmonary guidelines: pulmonary complications: hemoptysis and pneumothorax. Am J Respir Crit Care Med. 182(3):298-306, 2010 Aug 01. |
Review/Other-Dx |
N/A |
To present the CF Foundation's Pulmonary Therapies Committee recommendations for the treatment of hemoptysis and pneumothorax. |
The expert panel completed the survey twice, allowing refinement of recommendations. Numeric responses to the questions were summarized and applied to a priori definitions to determine levels of consensus. Recommendations were then developed to practical treatment questions based upon the median scores and the degree of consensus. These recommendations for the management of the patient with CF with hemoptysis and pneumothorax are designed for general use in most individuals but should be adapted to meet specific needs as determined by the individuals, their families, and their health care providers. |
4 |
| 61. Zhao T, Wang S, Zheng L, et al. The Value of 320-Row Multidetector CT Bronchial Arteriography in Recurrent Hemoptysis after Failed Transcatheter Arterial Embolization. J Vasc Interv Radiol. 28(4):533-541.e1, 2017 Apr. |
Observational-Dx |
135 patients |
To retrospectively assess the value of computed tomographic (CT) bronchial arteriography (BA) with 320-row multidetector CT in the management of patients with recurrent hemoptysis immediately after bronchial artery embolization (BAE). |
CT BA revealed an additional 22 abnormal vessels in the qualified 10 patients, and 8 patients were treated again within 24 hours after the first BAE based on multidetector CT findings. Of the 22 abnormal vessels, 16 were embolized, including 4 orthotopic arteries, 8 ectopic arteries, and 4 nonbronchial systemic arteries (NBSAs); the remaining 6 abnormal arteries were not embolized because of normal BA (n = 1), anatomic inaccessibility (n = 2), or cessation of hemoptysis with conservative therapy (n = 3). There were no further cases of recurrent hemoptysis after the second intervention, with a mean follow-up of 7.7 months ± 6.7. Overall, initial conventional BA missed 65% of potential bleeding arteries (22 of 34). After CT BA, 73% of the newly identified vessels (16 of 22) were embolized. |
2 |
| 62. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://www.acr.org/-/media/ACR/Files/Appropriateness-Criteria/RadiationDoseAssessmentIntro.pdf. |
Review/Other-Dx |
N/A |
To provide evidence-based guidelines on exposure of patients to ionizing radiation. |
No abstract available. |
4 |
