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Outcomes Following Bronchial Artery Embolisation for Haemoptysis in Cystic Fibrosis

  • Clinical Investigation
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Abstract

Background

Bronchial artery embolisation (BAE) is recommended for the treatment of massive haemoptysis in cystic fibrosis (CF), but there are no randomised controlled trials of this therapy and its role in sub-massive haemoptysis is unclear. This study aimed to determine the outcomes and safety of BAE in adults with CF.

Materials and Methods

All patients with CF undergoing BAE at our centre between March 2011 and January 2015 were identified at the time of the procedure. Patient records were reviewed at hospital discharge, death or one month post-procedure (whichever was soonest). Follow-up continued to January 2016. Severity of haemoptysis was classified as: massive (>240 ml/24 h or >100 ml/day for ≥2 days), moderate–severe (>20 ml/24 h) or mild (<20 ml/24 h).

Results

Twenty-seven patients underwent 51 BAE procedures over a median follow-up period of 26 months (range 1–54). Ten patients (37%) required more than one BAE during the study. BAE was performed for massive haemoptysis in 18 cases (35%). Haemoptysis recurred after 31 (61%) of BAE procedures with no difference in recurrence rates between massive and sub-massive haemoptysis. Side effects were reported after 61% of procedures with chest pain the most common adverse event . Mortality after first BAE in the study was 3.9% at 30 days and 14.8% at 12 months. No significant predictors of mortality were identified.

Conclusions

BAE is often effective in controlling haemoptysis but is associated with considerable morbidity and high recurrence rates.

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Authors’ Contributions

All authors contributed to the study design and manuscript development. WGF and PJB undertook the data analysis. WGF wrote the first draft of the manuscript.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK

    W. G. Flight

  2. University Hospital of South Manchester NHS Foundation Trust, Manchester, UK

    P. J. Barry, R. J. Bright-Thomas, S. Butterfield, R. Ashleigh & A. M. Jones

  3. Institute of Inflammation and Repair, University of Manchester, Manchester, UK

    R. J. Bright-Thomas & A. M. Jones

Authors
  1. W. G. Flight
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  2. P. J. Barry
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  3. R. J. Bright-Thomas
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  4. S. Butterfield
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  5. R. Ashleigh
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  6. A. M. Jones
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Corresponding author

Correspondence to W. G. Flight.

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On behalf of all authors, the corresponding author confirms that there is no conflict of interest.

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Informed consent does not apply as this was an evaluation of routine clinical practice with no patient identifiable data included.

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Flight, W.G., Barry, P.J., Bright-Thomas, R.J. et al. Outcomes Following Bronchial Artery Embolisation for Haemoptysis in Cystic Fibrosis. Cardiovasc Intervent Radiol 40, 1164–1168 (2017). https://doi.org/10.1007/s00270-017-1626-0

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  • DOI: https://doi.org/10.1007/s00270-017-1626-0

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