title: Bronchial artery embolization for the management of nonmassive hemoptysis in cystic fibrosis.
abstract: OBJECTIVE
  Hemoptysis is a common complication in patients with cystic fibrosis (CF). Current approaches to patients with hemoptysis include conservative medical therapy, bronchial artery embolization (BAE), and surgery. We investigated the effectiveness of early BAE on the outcome in patients with minor bleeding.
  
  
  METHODS
  We reviewed the clinical records from the Cystic Fibrosis Service for eight consecutive patients treated with medical therapy who had undergone early BAE and eight matched patients treated with conservative medical therapy alone.
  
  
  METHODS
  We assessed the mean number of bleeding episodes, pulmonary exacerbations, lung function (FEV(1)), Shwachman score, and Nottingham Health Profile (NHP) scores, the year before BAE and for the 3 ensuing years.
  
  
  RESULTS
  During a 3-year follow-up, patients who underwent embolization had significantly fewer bleeding episodes (p < 0.001) and pulmonary exacerbations (p < 0.006). Lung function declined significantly in both groups (p < 0.001). The modified Shwachman score declined significantly during the follow-up only in patients who did not undergo embolization (p < 0.001). Patients treated by early embolization had significantly better NHP scores, indicating a better quality of life (p < 0.05). None of the patients who underwent BAE had adverse reactions.
  
  
  CONCLUSIONS
  Early BAE in patients with CF who have nonmassive hemoptysis is an effective, safe therapeutic approach offering better long-term control of recurrent bleeding and quality of life than medical therapy alone.
authors.affiliation: Department of Pediatrics, University of Rome La Sapienza, Rome, Italy. mariano.antonelli1@tin.it
authors.forename: Mariano
authors.initials: M
authors.lastname: Antonelli
authors.forename: Fabio
authors.initials: F
authors.lastname: Midulla
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Tancredi
authors.forename: Filippo Maria
authors.initials: FM
authors.lastname: Salvatori
authors.forename: Enea
authors.initials: E
authors.lastname: Bonci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cimino
authors.forename: Isac
authors.initials: I
authors.lastname: Flaishman
mesh_terms: D001981:Bronchial Arteries; D003550:Cystic Fibrosis / Q000150:complications*; D004621:Embolization, Therapeutic; D006469:Hemoptysis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D011788:Quality of Life; D012189:Retrospective Studies; D055502:Secondary Prevention