Vincent Vidal MD, Presenter: Nothing to Disclose

Eric Therasse MD, Abstract Co-Author: Nothing to Disclose

Yves Berthiaume MD, Abstract Co-Author: Nothing to Disclose

Sebastien Bommart MD, Abstract Co-Author: Nothing to Disclose

Marie-France Giroux MD, Abstract Co-Author: Nothing to Disclose

Vincent Oliva MD, Abstract Co-Author: Nothing to Disclose

Gilles P. Soulez MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Cystic fibrosis (CF) patients currently living in adulthood often present with hemoptysis. Information is limited concerning survival and recurrence-free survival after bronchial artery embolization (BAE) for hemoptysis in these patients.

We reviewed the clinical records of all 297 CF patients who were hospitalized in our referral center from 1990 to 2003, to assess the safety, efficacy and impact of BAE on survival.

Forty-two life-threatening, bleeding episodes were treated by BAE in 30 patients (26.3 years old, range 15-58 years). Using Kaplan-Meier survival curves, recurrence-free survival after embolization was 66% at 4 years. Univariate analysis demonstrated a higher risk of recurrence when hypertrophied collateral vessels were embolized (p = 0.048), in patients with FEV(1) <50% (p = 0.018) and in diabetic patients (p = 0.016). Twenty-five patients could be matched with CF controls for age, sex and pulmonary function (FEV(1)) on the index year (embolization). At the inception of entry into this case-control comparison, patients who underwent BAE were more likely to have lower weight (50.2kg vs 53.3 kg), to be more oxygen-dependent (40% versus 8%) and to have multiresistant Pseudomonas respiratory infections (56% vs 32%). Survival at 4 years was 58% and 79% respectively in the BAE and control groups. Four (44%) deaths in the BAE group were due to respiratory failure occurring within the first 3 months after BAE. However, Using Cox proportional hazard modeling, BAE was not associated with a significantly increased risk of death. Infection with multiresistant Pseudomonas was linked with lower survival in the BAE and control groups together (p = 0.011). There were no adverse reactions with BAE although 12 (40%) patients had transient chest pain after the procedure. At the end of follow-up, lung transplantation was performed in 9 patients in the BAE group, and 2 patients in the control group.

CF patients who had hemoptysis requiring BAE were initially in a poorer general condition. After adjustment for the initial severity of illness, patients who underwent BAE did not have significantly lower survival rates than CF patients, matched for age, sex and FEV(1).

Vidal, V, Therasse, E, Berthiaume, Y, Bommart, S, Giroux, M, Oliva, V, Soulez, G, et al, , Hemoptysis in Cystic Fibrosis: Recurrent Bleeding Risk and Survival after Bronchial Artery Embolization.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4405027.html