Haemoptysis due to chronic tuberculosis vs. bronchiectasis: comparison of long-term outcome of arterial embolisation.

Abstract

OBJECTIVE:

To evaluate the factors that influence the outcome of bronchial arterial embolisation (BAE) in chronic tuberculosis (TB). In cases of chronic TB, non-bronchial systemic arteries (NBSA) provide a significant source of massive or recurrent haemoptysis.

DESIGN:

Medical records and radiological findings of 30 consecutive TB patients who underwent BAE were retrospectively analysed and compared with those of 19 bronchiectasis patients.

RESULTS:

Chronic TB patients had higher numbers of total feeding vessels (4.40 + or - 3.85 vs. 1.79 + or - 1.51, P = 0.007) and NBSA (1.57 + or - 1.63 vs. 0.42 + or - 0.61, P = 0.005) than the bronchiectasis patients. The number of embolisations required for obliterating feeding vessels (3.87 + or - 2.48 vs. 1.95 + or - 1.47, P = 0.004), and the incidence of incomplete embolisation (30% vs. 5.3%, P = 0.033) were also higher in the TB patients. Moreover, recurrence after BAE was more frequent in the TB patients (17/30, 56.7% vs. 5/19, 26.3%, P = 0.037). Male sex, past history of haemoptysis and incomplete embolisation during BAE were associated with higher recurrence of haemoptysis in chronic TB patients. The existence of a fungus ball or significant pleural thickening (> or =10 mm) was not found to influence the recurrence rate of haemoptysis.

CONCLUSION:

The haemoptysis recurrence rate was higher in chronic TB than in bronchiectasis; this was found to be related to incomplete feeding vessel embolisation.

• Authors: J-H Lee, S-Y Kwon, H-I Yoon, C J Yoon, K-W Lee, S-G Kang, C-T Lee
• Journal: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease (Int J Tuberc Lung Dis) Vol. 11 Issue 7 Pg. 781-7 (Jul 2007) ISSN: 1815-7920 [Electronic] France
• PMID: 17609054 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Angiography
• Bronchial Arteries
• Bronchiectasis (complications, diagnosis)
• Chronic Disease
• Cohort Studies
• Confidence Intervals
• Embolization, Therapeutic (adverse effects, methods)
• Female
• Follow-Up Studies
• Hemoptysis (epidemiology, etiology, physiopathology, therapy)
• Humans
• Incidence
• Male
• Middle Aged
• Probability
• Recurrence
• Retrospective Studies
• Risk Assessment
• Severity of Illness Index
• Tomography, X-Ray Computed
• Treatment Outcome
• Tuberculosis, Pulmonary (complications, diagnosis)