Tuberc Respir Dis.  2013 Mar;74(3):111-119.

Risk Factors Influencing Rebleeding after Bronchial Artery Embolization on the Management of Hemoptysis Associated with Pulmonary Tuberculosis

• Hwang HG
• Lee HS
• Choi JS
• Seo KH
• Kim YH
• Na JO

Abstract

BACKGROUND
Hemoptysis due to pulmonary tuberculosis (TB) frequently develops in Korea where the prevalence of TB is intermediate. The effect of bronchial artery embolization (BAE) on the control of massive hemoptysis has been well known. This study is designed to identify the risk factors contributing to rebleeding after BAE in patients with TB.
METHODS
We retrospectively evaluated risk factors and the time for rebleeding after BAE in 72 patients presenting with hemoptysis.
RESULTS
The overall immediate success rate of BAE was 93.1% (67 of 72 patients). Of the 29 patients (40.3%) who showed rebleeding after BAE, 13 patients experienced rebleeding within 1 month, and 14 patients between 1 month to 1 year. The existence of a shunt in angiographic finding, aspergilloma, and diabetes mellitus were risk factors of rebleeding after BAE in multivariate analysis.
CONCLUSION
BAE was very effective for obtaining immediate bleeding control in hemoptysis associated with active TB or post-TB sequelae. It is important to observe whether or not rebleeding occurs up to 1 year of BAE especially in TB patients with aspergilloma, DM, or a shunt. Even rebleeding can be managed well by second BAE.

Keyword

Aspergillosis; Bronchial Arteries; Embolization, Therapeutic; Hemoptysis; Tuberculosis

MeSH Terms

Aspergillosis
Bronchial Arteries
Diabetes Mellitus
Embolization, Therapeutic
Hemoptysis
Hemorrhage
Humans
Korea
Prevalence
Retrospective Studies
Risk Factors
Tuberculosis
Tuberculosis, Pulmonary

Figure

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  Figure 1 The cumulative hemoptysis control rate as depicted graphically by the Kaplan-Meier method: p=0.016; shunt (+) vs. shunt (-). BAE: bronchial artery embolization.

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  Figure 2 The cumulative hemoptysis control rate as depicted graphically by the Kaplan-Meier method: p=0.035; DM (+) vs. DM (-). DM: diabetes mellitus; BAE: bronchial artery embolization.

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  Figure 3 The cumulative hemoptysis control rate as depicted graphically by the Kaplan-Meier method: p=0.315; TB vs. post TB sequelae. TB: tuberculosis; BAE: bronchial artery embolization.

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  Figure 4 Flowchart of management and outcome after bronchial artery embolization in patients with hemoptysis. *Three patients died of massive hemoptysis.

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