DSA Features And Embolization Strategy Of Patients With Cryptogenic Hemoptysis And Non-cryptogenic Hemoptysis

Objective: To explore the DSA features in patients with cryptogenic hemoptysis and non-cryptogenic hemoptysis,Comparison of the two groups of patients with hemoptysis selected different embolization strategy after treatment and postoperative recurrence between the two groups;For the clinical treatment of patients with hemoptysis to provide medical treatment help.Methods: A total of 76 patients with hemoptysis who underwent digital subtraction angiography and interventional embolization from January 2013 to January 2016 were retrospective analysis,Collect clinical data and image data,All patients were divided into two groups: cryptogenic hemoptysis and non-cryptogenic hemoptysis under the guidance of imaging physician and interventional surgeon(above the deputy chief physician).Bronchial arteriography and the corresponding area of the bronchial systemic arterial angiography in 76 patients,Found that the abnormal responsibility of the blood vessels as far as possible super-selective intubation for embolization.The DSA features of the two groups were recorded and the differences in DSA features between the two groups were compared;According to the embolism strategy is divided into three embolization methods: Simple gelatin sponge embolization(method 1),simple embolization microspheres embolization(method 2),embolization microspheres,gelatin sponge or plus coil mixing embolization(method 3).Select the appropriate embolization method according to DSA features and intubation,Observe the hemostatic and follow up for 10-48 months,To evaluate the difference between the efficacy of the three embolization methods and the recurrence of the two groups;The above three embolization methods were compared in Overall 76 patients and to evaluate the effect of various embolization methods on efficacy;According to the responsibility of non systemic arterial vascular bronchial participate or not in the 76 patients: To evaluate the effect of non-bronchial circulation arterial blood supply on relapse.Statistical methods using SPSS 21.0 software,measurement data using independent sample t test,count data using chisquare test,P<0.05 for the difference was statistically significant.Results: The main blood vessels of patients with cryptogenic hemoptysis and non cryptogenic hemoptysis were abnormal changes of bronchial arteries and nonbronchial circulation arteries are also involved.The DSA of the two groups was consistent,The main DSA showed the Tortuous,thickening,disorder,different thickness,contrast agent spill,abnormal pulmonary infection,non-bronchial circulation artery involved in blood supply,bronchial artery and non-bronchial circulation arterial multiple blood vessels coincide with each other,aneurysm-like changes,bronchial artery-pulmonary artery Pulmonary venous fistula(shunt)etc.Tortuous,thickening,disorder,different thickness,abnormal lung staining,bronchial artery-pulmonary artery or pulmonary vein fistula(shunt)showed no significant difference(P>0.05)and Contrast extravasation,non-participation count bronchial circulation,aneurysmal changes,bilateral bronchial arteries abnormalities were statistically significant(P<0.05)between the two groups.76 patients with hemoptysis immediately stopped after interventional embolization,followed up 10-48 months,hemoptysis recurrence in 10 cases(13.16%),Hemoptysis relapse and three embolization methods on the efficacy of the effect were not statistically significant between the two groups(P>0.05).The 3 embolization strategies were compared in the 76 patients: Methods 2 and 3 were superior to the method 1,the difference was statistically significant(P<0.05),Methods 2 and 3 were not statistically significant(P> 0.05);Non-bronchial circulation arteries involved in blood supply than non-bronchial circulation arteries involved in blood supply more easily relapse in the 76 patients,The difference was statistically significant(P<0.05).Conclusion: The main blood vessels of patients with cryptogenic hemoptysis and non cryptogenic hemoptysis were abnormal changes of bronchial arteries and nonbronchial circulation arterial involvement in abnormal changes.Non-bronchial circulation arterial involvement and aneurysm-like changes appear more in noncryptogenic hemoptysis,While contrast agent spill and bilateral bronchial artery abnormalities in the cryptogenic hemoptysis group was obvious.There was no significant difference in the recurrent hemoptysis between the cryptogenic hemoptysis group and the non-cryptogenic hemoptysis group after the interventional embolization treatment.The non-bronchial circulation arteries were involved in blood supply,which easily led to hemoptysis recurrence,Short term and long term results were obtained in hemoptysis patients after embolization with a permanent embolic agent.