Abstract Objective To investigate the clinical effect of endovascular embolization (EVE) in the treatment of hemoptysis of systemic arterial origin in children. Methods A total of 20 children with hemoptysis of systemic arterial origin who underwent EVE from January 2016 to November 2017 were enrolled. The method for embolization was analyzed and the clinical outcome was evaluated. Results Offending vessels were bronchial artery (BA) in 14 children, non-bronchial systemic artery (NBSA) in 1 child, and BA and NBSA in 5 children. Of all the children, 13 underwent EVE with peripheral embolization agents and 7 underwent EVE with mechanical coils. A total of 41 offending vessels were embolized (34 BAs and 7 NBSAs) and all the children achieved immediate arrest of hemoptysis. Two children experienced recurrence within 6 months after EVE and 2 experienced recurrence with 6-24 months after EVE. The peripheral embolization agent group had a lower overall recurrence rate than the mechanical coil group[8% (1/13) vs 43% (3/7); P=0.10]. One child experienced intracranial ectopic embolism after surgery and had good quality of life during 20 months of follow-up after treatment. No other complications were observed. Conclusions EVE is a safe and effective method for the treatment of hemoptysis of systemic arterial origin in children and thus holds promise for clinical application.
ZHAO Qu-Ming,LIU Fang,WU Lin et al. Clinical effect of endovascular embolization in treatment of hemoptysis of systemic arterial origin in children[J]. CJCP, 2018, 20(10): 809-813.
ZHAO Qu-Ming,LIU Fang,WU Lin et al. Clinical effect of endovascular embolization in treatment of hemoptysis of systemic arterial origin in children[J]. CJCP, 2018, 20(10): 809-813.
Simon DR, Aronoff SC, Del Vecchio MT. Etiologies of hemoptysis in children:a systematic review of 171 patients[J]. Pediatr Pulmonol, 2017, 52(2):255-259.
[2]
Ramírez Mejía AR, Méndez Montero JV, Vásquez-Caicedo ML, et al. Radiological evaluation and endovascular treatment of hemoptysis[J]. Curr Probl Diagn Radiol, 2016, 45(3):215-224.
[3]
Dokumcu Z, Ozcan C, Alper H, et al. Pulmonary arteriovenous malformation in children[J]. Pediatr Int, 2015, 57(4):708-711.
[4]
Abdulhamid I, Forbes T. Severe hemoptysis from dilated systemic aberrant arteries supplying normal lung segments[J]. Pediatr Pulmonol, 2004, 38(6):477-482.
[5]
Nugent Z, Oliveira V, Maclusky I, et al. Bronchial arterypulmonary artery malformation as a cause of cryptogenic hemoptysis[J]. Pediatr Pulmonol, 2013, 48(9):930-933.
[6]
Sismanlar T, Aslan AT, Akkan K, et al. Successful embolization in childhood hemoptysis due to abnormal systemic arterial bleeding of the lung and review of the literature[J]. Clin Respir J, 2016, 10(6):693-697.
Walker CM, Rosado-de-Christenson ML, Martínez-Jiménez S, et al. Bronchial arteries:anatomy, function, hypertrophy, and anomalies[J]. Radiographics, 2015, 35(1):32-49.
[15]
Leyon JJ, Littlehales T, Rangarajan B, et al. Endovascular embolization:review of currently available embolization agents[J]. Curr Probl Diagn Radiol, 2014, 43(1):35-53.
[16]
Ittrich H, Klose H, Adam G. Radiologic management of haemoptysis:diagnostic and interventional bronchial arterial embolisation[J]. Rofo, 2015, 187(4):248-259.
Antonelli M, Midulla F, Tancredi G, et al. Bronchial artery embolization for the management of nonmassive hemoptysis in cystic fibrosis[J]. Chest, 2002, 121(3):796-801.
[19]
Barben J, Robertson D, Olinsky A, et al. Bronchial artery embolization for hemoptysis in young patients with cystic fibrosis[J]. Radiology, 2002, 224(1):124-130.
[20]
Wang GR, Ensor JE, Gupta S, et al. Bronchial artery embolization for the management of hemoptysis in oncology patients:utility and prognostic factors[J]. J Vasc Interv Radiol, 2009, 20(6):722-729.
[21]
Laborda A, Tejero C, Fredes A, et al. Posterior circulation stroke after bronchial artery embolization. A rare but serious complication[J]. Cardiovasc Intervent Radiol, 2013, 36(3):860-863.
[22]
Park JH, Kim DS, Kwon JS, et al. Posterior circulation stroke after bronchial artery embolization[J]. Neurol Sci, 2012, 33(4):923-926.
[23]
Fruchter O, Schneer S, Rusanov V, et al. Bronchial artery embolization for massive hemoptysis:long-term follow-up[J]. Asian Cardiovasc Thorac Ann, 2015, 23(1):55-60.