Transcatheter embolotherapy of pulmonary artery aneurysms as emergency treatment of hemoptysis in Behcet patients: experience of a referral center and a review of the literature

被引：0
作者：
Guillaume Voiriot
Antoine Parrot
Martine Antoine
Aude Gibelin
Samuel Haddad
Marie-France Carette
Muriel Fartoukh
Antoine Khalil
机构：
[1] Hôpital Tenon,Service de Réanimation Médico
[2] Hôpitaux Universitaires Est Parisien,chirurgicale
[3] Assistance Publique-Hôpitaux de Paris,Groupe de Recherche Clinique CARMAS, Faculté de Médecine
[4] Université Paris Est,Service d’Anatomie et Cytologie Pathologiques
[5] Hôpital Tenon,Faculté de Médecine
[6] Hôpitaux Universitaires Est Parisien,Service de Radiologie
[7] Assistance Publique-Hôpitaux de Paris,Service de Radiologie
[8] Université Pierre et Marie Curie Paris VI,Faculté de Médecine
[9] Hôpital Tenon,undefined
[10] Hôpitaux Universitaires Est Parisien,undefined
[11] Assistance Publique-Hôpitaux de Paris,undefined
[12] Hôpital Bichat Claude Bernard,undefined
[13] Hôpitaux Universitaires Paris Nord Val de Seine,undefined
[14] Assistance Publique-Hôpitaux de Paris,undefined
[15] Université Paris Diderot Paris VII,undefined
来源：
Internal and Emergency Medicine | 2018年 / 13卷
关键词：
Hemoptysis; Pulmonary artery aneurysm; Behcet’s disease; Behcet’s syndrome; Therapeutic embolization;
D O I：
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中图分类号：
学科分类号：
摘要：
Hemoptysis is a life-threatening complication of Behcet’s disease that is likely related to pulmonary artery aneurysm (PAA). Vascular interventional radiology may offer effective emergency therapeutic option, but has not been thoroughly investigated in this setting. A case series of a French referral center for hemoptysis combined with a literature review of case reports was conducted. Between 1995 and 2016, 12 patients were referred to our center for hemoptysis revealing or complicating the course of Behcet’s disease. Pulmonary artery aneurysm (PAA) was the mechanism of hemoptysis in ten patients, nine of whom were treated by a transcatheter embolotherapy. Combining an additional 8 case reports from the literature, 17 patients treated by transcatheter embolotherapy for PAA were analyzed. The duration of the course of Behcet’s disease was 22 months [IQR 3–45] at the time of PAA diagnosis. Transcatheter embolotherapy of PAA was successful for immediately controlling hemoptysis in all patients, without major complication except for one. Hemoptysis recurred in seven patients (41%) within 5 months [IQR 1–12]. The use of coils for transcatheter embolotherapy was associated with hemoptysis recurrence. A bronchosystemic hypervascularization related to the previously occluded PAA was the main mechanism of bleeding recurrence, leading to bronchosystemic artery embolization in four patients and surgery in two patients. Behcet’s disease-related hemoptysis is mainly due to PAA. Transcatheter embolotherapy should be considered as the first-line emergency treatment for PAA-related hemoptysis, in association with the immunosuppressive regimen. Hemoptysis may recur in half of the cases, involving preferentially a bronchosystemic arterial mechanism.
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页码：491 / 500
页数：9
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