Arterial embolization for hemoptysis in patients with chronic pulmonary tuberculosis and in patients with bronchiectasis

摘要

Background Previous studies suggest that recurrence of hemoptysis after arterial embolization is associated with the underlying pulmonary disease. Purpose To compare the baseline information and imaging findings in patients with hemoptysis due to either chronic pulmonary tuberculosis (PTB) or bronchiectasis and to identify predictors of rebleeding after embolization treatment. Material and Methods Clinical data of all consecutive chronic PTB and bronchiectasis patients who underwent arterial embolization for hemoptysis from January 2010 to January 2017 in a single center were reviewed. Baseline clinical information, radiological features, and rebleeding rates were compared between patients with chronic PTB and patients with bronchiectasis. Multivariate analysis was used to identify risk factors of recurrence in each patient group. Results Seventy-six patients with chronic PTB and 97 patients with bronchiectasis were included. Male sex, pleural thickening, multiple embolized arteries, and non-bronchial systemic arterial (NBSA) blood supply were more common in chronic PTB patients. The short-term and long-term recurrence-free rates were significantly lower in the chronic PTB group (P < 0.001). For the chronic PTB group, the presence of lung destruction and shunts were independent predictors of rebleeding during follow-up. Compared with patients who did not undergo computed tomography angiography (CTA) before the procedure, patients with CTA showed less recurrence in the first month after treatment (P = 0.019). Conclusion Chronic PTB patients had more extensive NBSA blood supply and experienced higher short- and long-term recurrence rates compared with bronchiectasis patients. The risk of rebleeding was high in chronic PTB patients with lung destruction and/or shunts.