Bronchial Artery Embolization in Pediatric Pulmonary Hemorrhage: A Single-Center Experience |
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| Affiliation: | 1. Pediatric Heart Center, Children’s Hospital of Fudan University, 399 Wanyuan Rd., Minhang, Shanghai 201102, China;2. Respiratory Department, Children’s Hospital of Fudan University, 399 Wanyuan Rd., Minhang, Shanghai 201102, China;3. Department of Pediatric Cardiology, Royal Hospital for Children, Glasgow, Scotland;1. Department of Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, New York;2. Charlotte Radiology, Charlotte, North Carolina;1. Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, kita-ku Okayama 700-8558, Japan;2. Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan;3. Department of General Thoracic Surgery, Okayama University Medical School, Okayama, Japan;4. Department of Surgery, Division of Thoracic Surgery, Kindai University Faculty of Medicine, Osaka-Sayama, Japan;1. Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612;2. Department of Radiation Oncology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612;3. University of South Florida, Morsani College of Medicine, Tampa, Florida;1. Department of Radiology, University Hospitals of Geneva, Geneva, Switzerland;2. Hepato- Pancreato-Biliary Centre, University Hospitals of Geneva, Geneva, Switzerland |
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| Abstract: | PurposeTo explore the safety and effectiveness of bronchial artery (BA) embolization (BAE) in children with pulmonary hemorrhage.Materials and MethodsBetween February 2016 and February 2019, 41 patients (median age, 4 y; interquartile range, 2.3-8 y; median weight, 17.6 kg; interquartile range, 12.3–23.6 kg) underwent BAE. The indication of BAE included massive hemoptysis in 10 patients (24.4%), recurrent hemoptysis in 18 patients (43.9%), and refractory anemia in 13 patients (31.7%). The main etiology of pulmonary hemorrhage included pulmonary hemosiderosis (58.5%), congenital heart disease (17.1%), and infection (14.6%). A retrospective review was conducted of clinical outcomes of BAE.ResultsThere were 44 embolization sessions, with a total of 137 embolized vessels. Pulmonary hemorrhage was caused by BAs in 30 cases, nonbronchial systemic arteries plus BAs in 10, and nonbronchial systemic arteries in 1. Embolic particles were used in 30 cases (24 polyvinyl alcohol PVA] and 6 microsphere), coils in 9 cases, and particles plus coils in 5 cases (4 PVA and 1 microsphere). Technical success (ability to embolize abnormal vessel) was achieved in 97.6% of patients (40 of 41), and clinical success (complete or partial resolution of hemoptysis within 30 days of embolization) was achieved in 90.2% (37 of 41). There was 1 procedure-related complication (2.4%) of cerebral infarction and 1 death from multiple-organ dysfunction (2.4%). Bleeding-free survival rates at 6, 12, 24, and 36 months were 92.5%, 83.9%, 83.9%, and 70.8%, respectively.ConclusionsBAE is a safe and effective procedure in children with pulmonary hemorrhage. |
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