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Bronchial Artery Embolization to Control Hemoptysis: Comparison of N-Butyl 2-Cyanoacrylate and Polyvinyl Alcohol Particles : 객혈 치료를 위한 기관지 동맥 색전술: 엔부틸시아노아크릴레이트와 폴리비닐 알코올 입자의 비교
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- Authors
- Advisor
- 윤창진
- Major
- 의과대학 임상의과학과
- Issue Date
- 2014-02
- Publisher
- 서울대학교 대학원
- Keywords
- hemoptysis ; bronchial artery embolization ; N-butyl 2-cyanoacrylate ; polyvinyl alcohol particle
- Description
- 학위논문 (석사)-- 서울대학교 대학원 : 임상의과학과, 2014. 2. 윤창진.
- Abstract
- Introduction: The purpose of this was study was to retrospectively compare the safety and effectiveness of two embolic agents (polyvinyl alcohol [PVA] particles vs. n-butyl 2-cyanoacrylate [NBCA]) for bronchial artery embolization (BAE) for control of hemoptysis.
Methods: Institutional Review Board approved this retrospective study
informed consent was waived. From January 2005 to December 2008, 406 patients (M:F = 242:164
6-92 years) with major hemoptysis underwent BAE using PVA particles (n = 293) or NBCA (n = 113). Technical and clinical success, complications, hemoptysis-free survival rates, the causes of recurrent hemoptysis were compared between PVA and NBCA groups. The differences in hemoptysis-free survival rates were also assessed between subgroups stratified to underlying diseases. The predictive factor for recurrent hemoptysis was identified with Cox proportional hazards regression model.
Results: Technical success was achieved in 93.9% (275 of 293) and 96.5% (109 of 113) of patients for PVA and NBCA, respectively (P = .463)
clinical success was achieved in 92.2% (270 of 293) and 96.5% (109 of 113) of patients for PVA and NBCA, respectively (P = .180). The 1-, 3-, and 5-year hemoptysis-free survival rates were, respectively, 77%, 68%, and 66% for PVA and 88%, 85%, and 83% for NBCA (P = .010). Recanalization of previously embolized vessels was more frequent in the PVA group (21.5%) than in the NBCA group (1.8%
P < .001). The NBCA group showed hemoptysis-free survival rates superior to the PVA group in patients with bronchiectasis (P = .016). The use of PVA (P = .050) and aspergilloma (P < .001) were predictive factors for recurrent hemoptysis.
Conclusions: BAE with NBCA provided higher hemoptysis-free survival rates compared with PVA particles without increasing complication rates. This improvement was evident in patients with bronchiectasis and seems to be caused by a more durable embolic effect than PVA particles.
- Language
- English
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