The Clinical Value Of Microcoils In The Treatment Of Hemoptysis By Bronchial Artery Embolization

Objective: To compare the clinical effect of two different embolization methods in the treatment of patients with massive hemoptysis by bronchial artery embolization.Methods: This article retrospectively analyzed 63 patients with massive hemoptysis who failed in conservative medical treatment and then underwent bronchial artery embolization from February 2017 to October 2019 in Tianjin Medical University General Hospital.The 127 target vessels embolized during the procedure were divided into two groups A and B according to whether the micro-coils were used.Among them,43 vessels in group A use Gelatin sponge(GS)particles and Polyvinyl alcohol(PVA)particles alone,and 84 vessels in group B use GS particles and PVA particles combined with micro-coils.The short-term(within 3 months)and medium to long-term(3-15 months)recurrence were followed up,and the clinical effect of the two embolic methods was analyzed and compared.Results: During the short-term follow-up,2 patients developed hemoptysis again,all of which recurred in 3 days after the procedure.Bronchial angiography revealed that each of the 2 patients had an in situ recanalization of the vessels,which was embolized by GS particles and PVA particles.During the medium to long-term follow-up,hemoptysis recurred in 2 patients,of which one occurred at 126 days after the procedure and the other occurred at 445 days after the procedure.Bronchial angiography revealed that each of the 2 patients had an in situ recanalization of the vessels,which was embolized by GS particles and PVA particles combined with micro-coils.There was no significant difference in the recanalization rate of in situ vessels between group A and group B during the short-term and medium to long-term follow-up(P> 0.05).Conclusion:1.BAE is a safe and effective procedure in treating massive hemoptysis.Utilizing the adhesion of GS particles and the non-degradability of PVA particles can complement each other to form a more effective mixed embolic agent.2.After using the mixture of GS particles and PVA particles for distal embolization,it is not necessary to use micro-coils to embolize the main trunk of target artery.The micro-coils does not reduce the recanalization rate of the target artery,but inconveniences the secondary embolization of relapsed patients,affects the superselection level of re-embolization,and increases the financial burden on patients.