Original Articles
Endovascular Treatment of Massive Hemoptysis by Bronchial Artery Embolization: Short-Term and Long-Term Follow-Up Over a 15-Year Period
M.A. de Gregorio
, J. Medrano, A. Mainar, E.R. Alfonso, M. Rengel
Corresponding author
madgariza@separ.es
Correspondence: Dr. M.A. de Gregorio. Unidad de Cirugía Mínimamente Invansiva Guiada por Imagen. Universidad de Zaragoza. Domingo Miral, s/n. 50009 Zaragoza. España
Correspondence: Dr. M.A. de Gregorio. Unidad de Cirugía Mínimamente Invansiva Guiada por Imagen. Universidad de Zaragoza. Domingo Miral, s/n. 50009 Zaragoza. España
Unidad de Cirugía Mínimamente Invasiva Guiada por Imagen (UCMI), Universidad de Zaragoza, Zaragoza, Spain
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"tienePdf" => "en" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "47" "paginaFinal" => "48" ] ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Domínguez, J. Ruiz-Manzano" "autores" => array:2 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Domínguez" ] 1 => array:3 [ "preGrado" => "Dr." "nombre" => "J." "apellidos" => "Ruiz-Manzano" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921290660116X?idApp=UINPBA00003Z" "url" => "/15792129/0000004200000002/v1_201305150237/S157921290660116X/v1_201305150237/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>" "titulo" => "Endovascular Treatment of Massive Hemoptysis by Bronchial Artery Embolization: Short-Term and Long-Term Follow-Up Over a 15-Year Period" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "49" "paginaFinal" => "56" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M.A. de Gregorio, J. Medrano, A. Mainar, E.R. Alfonso, M. Rengel" "autores" => array:5 [ 0 => array:5 [ "preGrado" => "Dr." "nombre" => "M.A." "apellidos" => "de Gregorio" "email" => array:1 [ 0 => "madgariza@separ.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Medrano" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Mainar" ] 3 => array:2 [ "nombre" => "E.R." "apellidos" => "Alfonso" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Rengel" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unidad de Cirugía Mínimamente Invasiva Guiada por Imagen (UCMI), Universidad de Zaragoza, Zaragoza, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. M.A. de Gregorio. Unidad de Cirugía Mínimamente Invansiva Guiada por Imagen. Universidad de Zaragoza. Domingo Miral, s/n. 50009 Zaragoza. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-10-28" "fechaAceptado" => "2005-01-25" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154237" "palabras" => array:3 [ 0 => "Bronchial artery embolization" 1 => "Hemoptysis" 2 => "Bronchial artery" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154236" "palabras" => array:3 [ 0 => "Embolización bronquial" 1 => "Hemoptisis" 2 => "Arteria bronquial" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To present our experience of using arterial embolization for the endovascular treatment of massive hemoptysis along with the results of follow-up over a 15-year period.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 401 patients with hemoptysis were referred to the minimally invasive surgery unit of the Hospital Universitario Lozano Blesa de Zaragoza between April 1989 and September 2004 for diagnosis and possible endovascular treatment. Of those patients, 314 met criteria for massive hemoptysis and treatment was attempted using embolization in 287 (91.4%). The most common cause of hemoptysis was bronchiectasis (n=99, 31.5%), followed by lesions due to tuberculosis (n=57, 18.1%) and chronic bronchitis (n=47,14.9%).</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Angiography of the bronchial arteries provided evidence to account for the hemoptysis in 287 patients (91.4%). The affected arteries were satisfactorily embolized in 281 (97.9%). Endovascular treatment was clinically successful in 256 of those patients (91.1%). Embolization had to be repeated during the hospital stay in 19 patients (6.7%) and was effective in 52.6 % of those cases. The 6 patients in whom embolization was not satisfactory underwent thoracotomy. The mean follow-up in 201 patients (71.5%) was 2372.5 days (range, 61–5475 days). Eighty patients (28.4%) were lost to follow-up for various reasons and at different points. Recurrence of hemoptysis occurred on 1 or more occasions in 45 patients (22.3%) but only 21 (10.4%) required repeat embolization. Minor complications that did not require treatment were observed in 88 patients (28.0%).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Embolization of bronchial arteries is a nonsurgical treatment that is safe and effective in patients with massive hemoptysis.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Presentar nuestra experiencia en el tratamiento endovascular de la hemoptisis masiva mediante embolización arterial y su seguimiento a lo largo de 15 años.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Desde abril de 1989 hasta septiembre de 2004 se remitió a la Unidad de Cirugía Mínimamente Invasiva del Hospital Universitario Lozano Blesa de Zaragoza a 401 pacientes por hemoptisis para diagnóstico y posible tratamiento endovascular. De ellos, 314 cumplían criterios de hemoptisis masiva y se intentó tratar mediante embolización a 287 (91,4%). La principal causa de hemoptisis observada fueron las bronquiectasias (n = 99; 31,5%), seguidas de lesiones de tuberculosis (n = 57; 18,1%) y bronquitis crónica (n = 47; 14,9%).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La angiografía bronquial reveló alteraciones arteriales que justificaban la hemoptisis en 287 pacientes (91,4%). Se pudo embolizar las arterias patológicas de forma satisfactoria en 281 (97,9%). El tratamiento endovascular tuvo éxito clínico en 256 (91,1%). En 19 pacientes (6,7%) se requirió durante su ingreso otra embolización, que fue eficaz en el 52,6%. En los 6 restantes se realizó toracotomía. El seguimiento medio, en 201 pacientes (71,5%), fue de 2.372,5 días (rango: 61-5.475 días). Se perdieron para el estudio 80 pacientes (28,4%) por diversas causas y en distintos momentos del seguimiento. El 22,3% (n = 45) presentó hemoptisis recidivante en una o más ocasiones, pero tan sólo 21 pacientes (10,4%) requirieron una nueva embolización. Se constataron 88 (28,0%) complicaciones menores que no precisaron otras medidas terapéuticas.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La embolización de arterias bronquiales es un tratamiento no quirúrgico seguro y efectivo en los pacientes que presentan hemoptisis masiva.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Managing life-threatening hemoptysis: has anything really changed?" 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 1 | 3 |
| 2024 October | 28 | 15 | 43 |
| 2024 September | 27 | 12 | 39 |
| 2024 August | 46 | 40 | 86 |
| 2024 July | 25 | 26 | 51 |
| 2024 June | 33 | 23 | 56 |
| 2024 May | 33 | 24 | 57 |
| 2024 April | 20 | 29 | 49 |
| 2024 March | 25 | 15 | 40 |
| 2024 February | 22 | 21 | 43 |
| 2023 March | 3 | 2 | 5 |
| 2023 February | 21 | 17 | 38 |
| 2023 January | 22 | 31 | 53 |
| 2022 December | 21 | 30 | 51 |
| 2022 November | 17 | 18 | 35 |
| 2022 October | 21 | 32 | 53 |
| 2022 September | 16 | 27 | 43 |
| 2022 August | 23 | 43 | 66 |
| 2022 July | 17 | 35 | 52 |
| 2022 June | 26 | 33 | 59 |
| 2022 May | 23 | 27 | 50 |
| 2022 April | 17 | 29 | 46 |
| 2022 March | 27 | 36 | 63 |
| 2022 February | 17 | 32 | 49 |
| 2022 January | 12 | 33 | 45 |
| 2021 December | 21 | 51 | 72 |
| 2021 November | 21 | 49 | 70 |
| 2021 October | 53 | 45 | 98 |
| 2021 September | 15 | 41 | 56 |
| 2021 August | 33 | 30 | 63 |
| 2021 July | 13 | 27 | 40 |
| 2021 June | 15 | 24 | 39 |
| 2021 May | 8 | 29 | 37 |
| 2021 April | 29 | 74 | 103 |
| 2021 March | 12 | 13 | 25 |
| 2021 February | 9 | 23 | 32 |
| 2021 January | 10 | 16 | 26 |
| 2020 December | 12 | 14 | 26 |
| 2020 November | 6 | 11 | 17 |
| 2020 October | 14 | 5 | 19 |
| 2020 September | 14 | 9 | 23 |
| 2020 August | 13 | 12 | 25 |
| 2020 July | 12 | 24 | 36 |
| 2020 June | 9 | 4 | 13 |
| 2020 May | 16 | 20 | 36 |
| 2020 April | 13 | 18 | 31 |
| 2020 March | 15 | 12 | 27 |
| 2020 February | 13 | 21 | 34 |
| 2020 January | 23 | 20 | 43 |
| 2019 December | 28 | 21 | 49 |
| 2019 November | 8 | 10 | 18 |
| 2019 October | 7 | 5 | 12 |
| 2019 September | 10 | 13 | 23 |
| 2019 August | 37 | 6 | 43 |
| 2019 July | 52 | 21 | 73 |
| 2019 June | 60 | 8 | 68 |
| 2019 May | 43 | 24 | 67 |
| 2019 April | 51 | 31 | 82 |
| 2019 March | 21 | 30 | 51 |
| 2019 February | 8 | 12 | 20 |
| 2019 January | 6 | 6 | 12 |
| 2018 December | 11 | 14 | 25 |
| 2018 November | 14 | 12 | 26 |
| 2018 October | 11 | 12 | 23 |
| 2018 September | 14 | 11 | 25 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 11 | 6 | 17 |
| 2018 March | 9 | 2 | 11 |
| 2018 February | 5 | 4 | 9 |
| 2018 January | 5 | 10 | 15 |
| 2017 December | 5 | 9 | 14 |
| 2017 November | 2 | 8 | 10 |
| 2017 October | 5 | 10 | 15 |
| 2017 September | 6 | 8 | 14 |
| 2017 August | 12 | 20 | 32 |
| 2017 July | 8 | 7 | 15 |
| 2017 June | 7 | 29 | 36 |
| 2017 May | 9 | 13 | 22 |
| 2017 April | 1 | 5 | 6 |
| 2017 March | 4 | 9 | 13 |
| 2017 February | 1 | 6 | 7 |
| 2017 January | 1 | 3 | 4 |
| 2016 December | 5 | 13 | 18 |
| 2016 November | 8 | 5 | 13 |
| 2016 October | 5 | 10 | 15 |
| 2016 September | 9 | 10 | 19 |
| 2016 August | 4 | 2 | 6 |
| 2016 July | 9 | 3 | 12 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 114 | 10 | 124 |
| 2015 September | 113 | 13 | 126 |
| 2015 August | 108 | 17 | 125 |
| 2015 July | 127 | 9 | 136 |
| 2015 June | 67 | 8 | 75 |
| 2015 May | 102 | 8 | 110 |
| 2015 April | 91 | 9 | 100 |
| 2015 March | 99 | 16 | 115 |
| 2015 February | 88 | 13 | 101 |
| 2015 January | 91 | 13 | 104 |
| 2014 December | 114 | 9 | 123 |
| 2014 November | 126 | 9 | 135 |
| 2014 October | 159 | 17 | 176 |
| 2014 September | 109 | 14 | 123 |
| 2014 August | 103 | 7 | 110 |
| 2014 July | 96 | 11 | 107 |
| 2014 June | 107 | 6 | 113 |
| 2014 May | 121 | 11 | 132 |
| 2014 April | 129 | 9 | 138 |
| 2014 March | 108 | 7 | 115 |
| 2014 February | 109 | 11 | 120 |
| 2014 January | 81 | 6 | 87 |
| 2013 December | 87 | 15 | 102 |
| 2013 November | 93 | 7 | 100 |
| 2013 October | 76 | 9 | 85 |
| 2013 September | 68 | 10 | 78 |
| 2013 August | 54 | 14 | 68 |
| 2013 July | 62 | 9 | 71 |
| 2013 June | 59 | 14 | 73 |
| 2013 May | 55 | 9 | 64 |
| 2013 April | 40 | 7 | 47 |
| 2013 March | 13 | 1 | 14 |
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