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• W3157846033 abstract "Bronchial artery embolization (BAE) is a well-established intervention for treating benign and malignant causes of hemoptysis with high success rate from 70-99%; a subset of these procedures involve bronchial artery chemoperfusion, which has been used in palliation of lung malignancies. One of the dreaded complications of BAE is non-target embolization resulting in spinal cord ischemia, occurring in 0.6-4.4% of patients. This study aims to examine whether the adjunct use of CBCT with digital subtraction angiography (DSA) has an impact on BAE interventions. Twenty-one (10M, 11F) patients of mean age 55.5 who underwent DSA with CBCT prior to BAE from 2010 to 2020 were evaluated for single-institutional retrospective study. Retrospective analysis of the dictated reports were performed in conjunction with the available stored images and findings were summarized into 3 categories: 1) CBCT added no benefit; 2) CBCT added benefit (i.e., increased diagnostic confidence) without change in procedural management; 3) CBCT added benefit with change in intraprocedural management. The frequency and percentage of each category were calculated. 14/21 patients (66.7%) (95% CI: 0.47-0.87) were placed into category 2 whereby CBCT increased diagnostic confidence for embolization. The remaining 7/21 (33.3%) patients (95% CI: 0.13-0.53) were placed into category 3. In 3 of these patients, CBCT resulted in microcatheter repositioning to a selective bronchial artery branch to avoid nontarget embolization of a spinal artery. In 2 patients, CBCT confirmed normal tissue perfusion resulting in microcatheter repositioning to find an alternate source. In the remaining 2 patients, CBCT showed additional intercostal collaterals to ipsilateral bronchial arteries, which were then embolized. No cases were placed into category 1. One patient (4.8%) had a complication of spinal cord ischemia likely related to non-target embolization via small posterior radiculomedullary arterial branches, which in retrospect were seen on CBCT but not DSA. No other complications were seen. Adjunct use of CBCT during BAE provides additional information beyond DSA. This resulted in increased diagnostic confidence 67% of the time and in 33% of cases resulted in intraprocedural change in management, often to avoid non-target embolization via DSA-occult spinal arteries." @default.
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• W3157846033 date "2021-05-01" @default.
• W3157846033 modified "2023-10-14" @default.
• W3157846033 title "Abstract No. 48 Usefulness of cone-beam computed tomography during bronchial artery embolization" @default.
• W3157846033 doi "https://doi.org/10.1016/j.jvir.2021.03.466" @default.
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