We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Combined therapy with bronchial artery embolization and tranexamic acid for hemoptysis.
- Authors
Lee, Hyoung Nam; Park, Hong Suk; Hyun, Dongho; Cho, Sung Ki; Park, Kwang Bo; Shin, Sung Wook; Soo Do, Young
- Abstract
<bold>Background: </bold>While most previous studies have viewed tranexamic acid as a bridging or temporary therapy, our preliminary study offers insights into the combined therapy of antifibrinolytic agent with endovascular treatment for hemoptysis.<bold>Purpose: </bold>To investigate the feasibility and safety of combined therapy, to analyze factors affecting the outcomes of combined therapy, and to compare the effectiveness of combined therapy between groups with different etiologies.<bold>Material and Methods: </bold>Between January 2011 and December 2014, 64 patients (33 men, mean age 64.6 years) underwent combined therapy for hemoptysis. The median follow-up time was 14.7 months (range 174-2435 days). Patients were divided into a tuberculosis group (GroupTB, n=37) and a non-tuberculosis group (Groupnon-TB, n=27).<bold>Results: </bold>Embolotherapy was technically successful in 62/64 (96.9%) cases. The immediate clinical success rate was 96.8% (60/62). The short-term and long-term recurrence rates were 12.9% (n=8) and 19.4% (n=12), respectively. The one-, two-, and four-year recurrence-free survival rates were 61%, 49%, and 32%, respectively. There was no significant survival difference between the two groups. Suboptimal embolization was a significant risk factor for immediate clinical failure (odds ratio 29.624, P = 0.023). Optimal embolization (hazard ratio [HR] 0.199, P = 0.023) and older age (HR 0.956, P = 0.013) were significantly associated with lower recurrence risk.<bold>Conclusion: </bold>Combined therapy is an effective and safe treatment modality for hemoptysis of various etiologies, with potential benefits for short-term recurrence vis-a-vis current literature evidence. Suboptimal embolization was the most important modifiable risk factor for treatment failure and recurrence after combined therapy.
- Subjects
BRONCHIAL arteries; HEMOPTYSIS; ANTIFIBRINOLYTIC agents; ENDOVASCULAR surgery; TRANEXAMIC acid; ODDS ratio; PILOT projects; THERAPEUTIC embolization; RETROSPECTIVE studies; MENTAL health surveys; COMBINED modality therapy
- Publication
Acta Radiologica, 2021, Vol 62, Issue 5, p610
- ISSN
0284-1851
- Publication type
journal article
- DOI
10.1177/0284185120933984