Purpose

To explore the safety and effectiveness of bronchial artery (BA) embolization (BAE) in children with pulmonary hemorrhage.

Materials and Methods

Between February 2016 and February 2019, 41 patients (median age, 4 y; interquartile range, 2.3-8 y; median weight, 17.6 kg; interquartile range, 12.3–23.6 kg) underwent BAE. The indication of BAE included massive hemoptysis in 10 patients (24.4%), recurrent hemoptysis in 18 patients (43.9%), and refractory anemia in 13 patients (31.7%). The main etiology of pulmonary hemorrhage included pulmonary hemosiderosis (58.5%), congenital heart disease (17.1%), and infection (14.6%). A retrospective review was conducted of clinical outcomes of BAE.

Results

There were 44 embolization sessions, with a total of 137 embolized vessels. Pulmonary hemorrhage was caused by BAs in 30 cases, nonbronchial systemic arteries plus BAs in 10, and nonbronchial systemic arteries in 1. Embolic particles were used in 30 cases (24 polyvinyl alcohol [PVA] and 6 microsphere), coils in 9 cases, and particles plus coils in 5 cases (4 PVA and 1 microsphere). Technical success (ability to embolize abnormal vessel) was achieved in 97.6% of patients (40 of 41), and clinical success (complete or partial resolution of hemoptysis within 30 days of embolization) was achieved in 90.2% (37 of 41). There was 1 procedure-related complication (2.4%) of cerebral infarction and 1 death from multiple-organ dysfunction (2.4%). Bleeding-free survival rates at 6, 12, 24, and 36 months were 92.5%, 83.9%, 83.9%, and 70.8%, respectively.

Conclusions

BAE is a safe and effective procedure in children with pulmonary hemorrhage.

中文翻译：

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小儿肺出血中的支气管动脉栓塞：单中心经验。

目的

探讨支气管动脉栓塞术（BAE）在肺出血患儿中的安全性和有效性。

材料和方法

在2016年2月至2019年2月之间，接受BAE的41例患者（中位年龄为4岁；四分位间距为2.3-8岁；中位体重为17.6公斤；四分位间距为12.3至23.6公斤）。BAE的适应症包括10例大咯血（24.4％），18例反复咯血（43.9％）和13例难治性贫血（31.7％）。肺出血的主要病因包括肺含铁血黄素沉着症（58.5％），先天性心脏病（17.1％）和感染（14.6％）。对BAE的临床结局进行了回顾性审查。

结果

共进行了44次栓塞会议，共有137个栓塞血管。肺出血是由BAs引起的30例，非支气管系统动脉加BAs的引起的，以及1个非支气管系统动脉的致病的。1例使用栓塞颗粒的患者有30例（24聚乙烯醇[PVA]和6个微球体），盘绕9例， 5例（4个PVA和1个微球体）中的颗粒和线圈。97.6％的患者获得了技术成功（栓塞异常血管的能力）（41个中的40个），临床成功（栓塞后30天内完全或部分解决咯血）达到90.2％（41个中的37个）。有1例与手术相关的并发症（2.4％），1例多器官功能障碍致死（2.4％）。在6、12、24和36个月时无出血生存率分别为92.5％，83.9％，83.9％和70.8％。

结论

对于患有肺出血的儿童，BAE是一种安全有效的方法。