0
Clinical Investigations: PLUMONARY EMBOLISM |

Bronchial Artery Embolization for the Management of Nonmassive Hemoptysis in Cystic Fibrosis*

Mariano Antonelli, MD; Fabio Midulla, MD; Giancarlo Tancredi, MD; Filippo Maria Salvatori, MD; Enea Bonci, PhD; Giuseppe Cimino, MD; Isac Flaishman, MD
Author and Funding Information

*From the Department of Pediatrics (Drs. Antonelli, Midulla, Tancredi, Cimino, and Flaishman), Cystic Fibrosis Center, and Department of Radiology (Dr. Salvatori), Biochemistry Laboratory (Dr. Bonci), Department of Pediatrics, University of Rome “La Sapienza,” Rome, Italy.

Correspondence to: Mariano Antonelli, MD, Director of Cystic Fibrosis Center, Istituto di Clinica Pediatrica, Policlinico Umberto I, Viale Regina Elena 234, 00161 Rome, Italy; e-mail: mariano.antonelli1@tin.it



Chest. 2002;121(3):796-801. doi:10.1378/chest.121.3.796
Text Size: A A A
Published online

Study objectives: Hemoptysis is a common complication in patients with cystic fibrosis (CF). Current approaches to patients with hemoptysis include conservative medical therapy, bronchial artery embolization (BAE), and surgery. We investigated the effectiveness of early BAE on the outcome in patients with minor bleeding.

Design, patients, and interventions: We reviewed the clinical records from the Cystic Fibrosis Service for eight consecutive patients treated with medical therapy who had undergone early BAE and eight matched patients treated with conservative medical therapy alone.

Measurements: We assessed the mean number of bleeding episodes, pulmonary exacerbations, lung function (FEV1), Shwachman score, and Nottingham Health Profile (NHP) scores, the year before BAE and for the 3 ensuing years.

Results: During a 3-year follow-up, patients who underwent embolization had significantly fewer bleeding episodes (p < 0.001) and pulmonary exacerbations (p < 0.006). Lung function declined significantly in both groups (p < 0.001). The modified Shwachman score declined significantly during the follow-up only in patients who did not undergo embolization (p < 0.001). Patients treated by early embolization had significantly better NHP scores, indicating a better quality of life (p < 0.05). None of the patients who underwent BAE had adverse reactions.

Conclusions: Early BAE in patients with CF who have nonmassive hemoptysis is an effective, safe therapeutic approach offering better long-term control of recurrent bleeding and quality of life than medical therapy alone.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543