VAI TRÒ CAN THIỆP NỘI MẠCH TRONG ĐIỀU TRỊ HO RA MÁU Ở BỆNH NHÂN LAO PHỔI

Abstract

Objective: the study aimed to evaluate the effectiveness and safety of endovascular treatment in tuberculosis patient with hemoptysis and evaluate the recurrence rate of hemoptysis after embolization. Methods: The retrospective cohort study of patients with hemoptysis due to pulmonary tuberculosis admitted to Cho Ray Hospital during the period from 2020 to 2/2023. Results: The study was carried out on 81 patients (male to female ratio: 2,1/1; mean age 54,9). 13,6% patients had active TB and 86,4% patients had inactive TB (post-tuberculosis sequelae). A total of 227 bleeding arteries were found, an average of 2,8 arteries per patient. Important angiographics findings were: neovascularity and hypervascularity (93,8%), vascular hypertrophy and tortuosity (86,4%), shunting (39,5%), aneurysm formation (9,9%) and active extravasation (1,2%). Immediate clinical success achieved was 97,5% (79/81 patients) and 30,4% of patients had recurrent over 6 month. The risk factors associated with recurrence were pulmonary aspergilloma (HR = 3,77; p = 0,002) and the presence of shunts (HR = 4,81; p = 0,009). One patient (1,2%) had posterior circulation infarction after embolization (serve complications). Conclusions: Despite high hemoptysis recurrence rates, endovascular treatment is a safe and effective method for the management of hemoptysis in patient with tuberculosis. Keywords: massive hemoptysis, embolized arteries, clinical success, early recurrent.