Bronşiyal Arter Embolizasyonunda Kullanılan Partikül Boyutu ile İşlem Başarısı ve Komplikasyonlar Arasındaki İlişkinin Değerlendirilmesi

Year 2024, Volume: 9 Issue: 1, 84 - 88, 11.03.2024

Mustafa Özdemir , Ayşe Şule Ateş , Mehmet Halil Öztürk

https://doi.org/10.26453/otjhs.1408872

Abstract

Amaç: Hemoptizi pulmoner veya bronşiyal vasküler sistemden kaynaklanan kanın ağızdan gelmesidir. Bu çalışmanın amacı bronşiyal arter embolizasyonu (BAE) yapılan hastalarda kullanılan partikül boyutunun işlem başarısı ve komplikasyonlar açısından önemini incelemekti.
Materyal ve Metot: Polivinil alkol partikülleri (PVA) kullanılarak BAE yapılan hastaların verileri retrospektif olarak toplanmıştır. Hemoptizi etiyolojisi, lokalizasyonu ve lezyon tipi, kullanılan embolize edici ajan boyutu ve postoperatif komplikasyonlar kaydedildi. 30 günlük takip sonuçları değerlendirildi.
Bulgular: Çalışmaya 56 hasta dahile dildi. 30 hastada (%53,6) 300-500 mikron, 26 hastada (%46,4) ise 500-700 mikron boyutlu partiküler ajanlar kullanıldı. İşlem sonrası hastaların %92,9'unda kanama durdu ve 30 gün içerisinde tekrarlamadı. 300-500 mikron ile 500-700 mikron boyutlu partikül kullanılan hastalar karşılaştırıldığında başarısı ve komplikasyonlar açısından anlamlı farklılık saptanmadı.
Sonuç: BAE, hemoptizi tedavisi için tekrar tekrar yapılabilen güvenli, etkili ve minimal invaziv bir yöntemdir. PVA partiküllerinin BAE’nda kullanılabilecek etkin ve güvenli bir ajan olduğu gösterildi.

Keywords

Embolizasyon, hemoptizi, partiküler ajan

Evaluation of The Relationship Between the Selected Particle Size and Procedure Success and Complications in Bronchial Artery Embolisation

Abstract

Objective: Hemoptysis refers to the discharge of blood, which originates from the lungs or bronchial system through the mouth. This study aimed to examine the importance of the particle size used in patients undergoing bronchial artery embolisation (BAE) regarding procedure success and complications.
Materials and Methods: Data from patients who underwent BAE using polyvinyl alcohol (PVA) particles were collected retrospectively. Hemoptysis etiology and localisation, lesion type, the size of the embolising agent used, and postoperative complications were recorded. Thirty-day follow-up results were evaluated.
Results: Fifty-six patients were included in the study. The size of the PVA particles used was 300-500 microns in 30 patients (53.6%) and 500-700 microns in 26 patients (46.4%). Bleeding completely stopped in 92.9% of the cases within 30 days after the procedure. Procedure success or complications did not significantly differ between the patient groups in which 300-500 micron and 500-700 micron particles were used during BAE.
Conclusion: BAE is a safe, effective, and minimally invasive method that can be performed repeatedly to treat hemoptysis. This study showed that regardless of size, PVA particles were effective and safe agents that could be used during this procedure.

Keywords

Embolisation, hemoptysis, particular agent

References

• 1. Fu Z, Li X, Cai F, et al. Microspheres present comparable efficacy and safety profiles compared with polyvinyl alcohol for bronchial artery embolization treatment in hemoptysis patients. J Transl Med. 2021;19(1):422. doi:10.1186/s12967-021-02947-7
• 2. Dumanlı A, Aydın S. Evaluation of patients presenting with the complaint of hemoptysis. KTD. 2022;23(3):344-349. doi:10.18229/kocatepetip.977399
• 3. Çolak M, Aslaner MA. Etiological evaluation in patients presenting with hemoptysis. Sakarya Tıp Dergisi. 2019;9(4):626-631. doi:10.31832/smj.563499
• 4. Xu HD, Yang L, Hu SB. Embosphere microspheres size for bronchial artery embolization in patients with hemoptysis caused by bronchiectasis: A retrospective comparative analysis of 500-750 versus 700-900 µm microspheres. BMC Pulm Med. 2023. doi:10.21203/rs.3.rs-3392654/v1
• 5. Fidan A, Ozdoğan S, Oruç O, Salepçi B, Ocal Z, Cağlayan B. Hemoptysis: A retrospective analysis of 108 cases. Respir Med. 2002;96(9):677-680. doi:10.1053/rmed.2002.1359
• 6. Atchinson PRA, Hatton CJ, Roginski MA, Backer ED, Long B, Lentz SA. The emergency department evaluation and management of massive hemoptysis. Am J Emerg Med. 2021;50:148-155. doi:10.1016/j.ajem.2021.07.041
• 7. Yoon W, Kim JK, Kim YH, Chung TW, Kang HK. Bronchial and nonbronchial systemic artery embolization for life-threatening hemoptysis: A comprehensive review. Radiographics. 2002;22(6):1395-1409. doi:10.1148/rg.226015180
• 8. Piacentino F, Fontana F, Curti M, Coppola A, Venturini M. Bronchial artery embolization with an ethylene vinyl alcohol copolymer agent (Squid) and polyvinyl alcohol particles for treatment of hemoptysis. Diagn Interv Radiol. 2021;27(6):786-788. doi:10.5152/dir.2021.20601
• 9. Oğuz Ş. Endovascular treatment in the management of hemoptysis: Single center experience and early stage clinical results. SDÜ Tıp Fak Derg. 2020;27(1):17-22. doi:10.17343/sdutfd.542696
• 10. Dorji K, Hongsakul K, Jutidamrongphan W, Oofuvong M, Geater S. Bronchial artery embolization in life-threatening hemoptysis: Outcome and predictive factors. J Belg Soc Radiol. 2021; 105(1):5. doi:10.5334/jbsr.2310
• 11. Lee JH, Yoon CJ, Jung YS, Choi WS, Lee CH, Lee GM. Comparison of n-butyl-2-cyanoacrylate and polyvinyl alcohol particles for bronchial artery embolisation in primary lung cancer: A retrospective cohort study. Respir Res. 2022;23(1):257. doi:10.1186/s12931-022-02183-7
• 12. Nilpatrewar G, Ramraje N, Pujari V, Mohan S, Meshram P. A longitudinal study evaluating indications, efficacy and complications of bronchial artery embolisation. J Clin Diagn Res. 2022;16(9):34-37. doi:10.7860/JCDR/2022/58109.16954
• 13. Idil Soylu A, Uzunkaya F, Belet Ü, Akan H. Selective transarterial embolization of acute renal hemorrhage: A retrospective study. Minim Invasive Ther Allied Technol. 2020;29(6):326-333. doi:10.1080/13645706.2019.1655063
• 14. Panda A, Bhalla AS, Goyal A. Bronchial artery embolization in hemoptysis: A systematic review. Diagn Interv Radiol. 2017;23(4):307-317. doi:10.5152/dir.2017.16454
• 15. 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. 2015;26(12):1806-1813.e1. doi:10.1016/j.jvir.2015.08.019