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Multidetector computed tomography angiography prior to bronchial artery embolization helps detect culprit ectopic bronchial arteries and non-bronchial systemic arteries originating from subclavian and internal mammary arteries and improve hemoptysis-free early survival rate in patients with hemoptysis

  • Vascular-Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To compare the average number of culprit arteries per patient, clinical success rate, and hemoptysis-free survival rate between hemoptysis patients with multidetector computed tomography (MDCT) angiography prior to bronchial artery embolization (BAE) and those without preprocedural MDCT angiography

Methods

This retrospective study was approved by the institutional review board with waiver of patient informed consent. From September 2012 to March 2017, 157 consecutive hemoptysis patients had been undergoing BAE. Among them, 106 patients received preprocedural MDCT angiography (MDCT group), while 51 patients did not receive preprocedural MDCT angiography (control group). The average number of culprit arteries per patient, clinical success rate, and hemoptysis-free survival rate were compared between the two groups.

Results

The average number of culprit ectopic bronchial arteries and that of non-bronchial systemic arteries originating from the subclavian and internal mammary arteries per patient in the MDCT group were both significantly higher than those in the control group (0.15 ± 0.51 vs 0.04 ± 0.20, p = 0.022, and 0.17 ± 0.56 vs 0.08 ± 0.39, p = 0.040, respectively). The clinical success rate of BAE with preprocedural MDCT angiography tended to be higher than that without MDCT angiography (97.2 vs 88.2%, p = 0.057). Importantly, patients in the MDCT group had a significantly higher hemoptysis-free early survival rate compared to those in the control group (96.1 vs 86.7%, p = 0.031).

Conclusions

Preprocedural MDCT angiography helps detect culprit ectopic bronchial arteries and non-bronchial systemic arteries originating from subclavian and internal mammary arteries during BAE, and can improve the hemoptysis-free early survival rate, which could be recommended as a regular examination prior to BAE in patients with hemoptysis.

Key Points

• Preprocedural MDCT angiography helps detect culprit ectopic bronchial arteries and NBSAs originating from subclavian and internal mammary arteries during BAE.

• Conducting MDCT angiography prior to BAE can improve hemoptysis-free early survival rate in hemoptysis patients.

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Abbreviations

BAE:

Bronchial artery embolization

MDCT:

Multidetector computed tomography

NBSAs:

Non-bronchial systemic arteries

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Acknowledgments

We thank Professors Hong-Li Bai and Pei-Ju Zhu (Department of Radiology, West China Hospital, Sichuan University) for hel** with the imaging analysis.

Funding

The authors state that this work has not received any funding.

Author information

Author notes

  1. Pei-Jun Li and He Yu contributed equally to this work.

Authors and Affiliations

  1. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Road, Chengdu, 610041, China

    Pei-Jun Li, Ye Wang, Fa-Ming Jiang, **ao-Ou Li & Zong-An Liang

  2. Department of Critical Care Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Road, Chengdu, 610041, China

    He Yu

  3. The Center of Interventional Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Road, Chengdu, 610041, China

    Ye Wang & Fa-Ming Jiang

  4. Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Chengdu, No. 8, Zhimin Road, Chengdu, 610041, China

    Wei Wang

  5. West China School of Medicine, Sichuan University, No. 37, Guoxue Road, Chengdu, 610041, China

    Yu Wang

Authors
  1. Pei-Jun Li
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Corresponding author

Correspondence to Ye Wang.

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Guarantor

The scientific guarantor of this publication is Ye Wang at West China Hospital, Sichuan University.

Conflict of interest

The authors declare that they have no competing interests.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the institutional review board, as this was a retrospective study.

Ethical approval

Institutional review board approval was obtained.

Methodology

• Retrospective

• Observational study

• Performed at one institution

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Li, PJ., Yu, H., Wang, Y. et al. Multidetector computed tomography angiography prior to bronchial artery embolization helps detect culprit ectopic bronchial arteries and non-bronchial systemic arteries originating from subclavian and internal mammary arteries and improve hemoptysis-free early survival rate in patients with hemoptysis. Eur Radiol 29, 1950–1958 (2019). https://doi.org/10.1007/s00330-018-5767-6

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  • DOI: https://doi.org/10.1007/s00330-018-5767-6

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