title: Bleeding Complications After Endoscopic Lung Volume Reduction Coil Treatment: A Retrospective Observational Study.
abstract: BACKGROUND
  Endoscopic lung volume reduction coil (LVRC) treatment is an option for selected patients with severe emphysema. This study was conducted to determine the incidence of bleeding complications after LVRC treatment, to identify risk factors and to discuss treatment options in case of hemoptysis which does not resolve spontaneously.
  
  
  METHODS
  Retrospective observational study conducted in the Department of Respiratory Medicine at the University Medical Center Hamburg-Eppendorf in all subjects in whom LVRC treatment was performed between April 1, 2012 and September 30, 2015.
  
  
  RESULTS
  During the study period, 101 LVRC procedures were performed in 62 subjects. Early post-procedural bleeding was encountered in 65.3% of cases. Hemoptysis was significantly more likely to occur in patients receiving acetylsalicylic acid (P=.005). Hemoptysis resolved spontaneously in 98.5% of cases. In the one case (1.5%) with persistent hemoptysis, bronchial artery embolization was successful in terminating bleeding. Hospital stay was significantly prolonged in subjects with hemoptysis (P=.01). No significant differences were found between subjects with or without hemoptysis in terms of chronic obstructive pulmonary disease exacerbations within four weeks after LVRC treatment (P=.18). Late bleeding complications were observed in 3 subjects (3.0%). In 2 of these cases, bronchial artery embolization was performed and bleeding was successfully terminated.
  
  
  CONCLUSIONS
  Self-limiting low volume bleeding is a common finding in the first days after LVRC treatment. However, persistent bleeding may occur in the early post-procedural phase and late after LVRC treatment. In these cases, bronchial artery embolization was a feasible and successful approach to terminating bleeding.
authors.affiliation: Departamento de Medicina Respiratoria, University Medical Center Hamburg-Eppendorf, Hamburgo, Alemania.
authors.forename: Marcel
authors.initials: M
authors.lastname: Simon
authors.affiliation: Departamento de Radiología Diagnóstica e Intervencionista, University Medical Center Hamburg-Eppendorf, Hamburgo, Alemania.
authors.forename: Harald
authors.initials: H
authors.lastname: Ittrich
authors.affiliation: Departamento de Medicina Respiratoria, University Medical Center Hamburg-Eppendorf, Hamburgo, Alemania.
authors.forename: Lars
authors.initials: L
authors.lastname: Harbaum
authors.affiliation: Departamento de Medicina Respiratoria, University Medical Center Hamburg-Eppendorf, Hamburgo, Alemania.
authors.forename: Tim
authors.initials: T
authors.lastname: Oqueka
authors.affiliation: Departamento de Medicina Intensiva, University Medical Center Hamburg-Eppendorf, Hamburgo, Alemania.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kluge
authors.affiliation: Departamento de Medicina Respiratoria, University Medical Center Hamburg-Eppendorf, Hamburgo, Alemania. Electronic address: klose@uke.de.
authors.forename: Hans
authors.initials: H
authors.lastname: Klose
mesh_terms: D000368:Aged; D001241:Aspirin / Q000009:adverse effects; D001981:Bronchial Arteries; D001999:Bronchoscopy / Q000009:adverse effects* / Q000379:methods; D004621:Embolization, Therapeutic; D004646:Emphysema / Q000601:surgery*; D005260:Female; D005471:Fluoroscopy; D006469:Hemoptysis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006474:Hemorrhagic Disorders / Q000139:chemically induced; D006489:Hemostatic Techniques; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D007902:Length of Stay / Q000706:statistics & numerical data; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D011013:Pneumonectomy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
keywords: Emphysema; Endoscopic lung volume reduction; Endoscopic lung volume reduction coil; Enfisema; Interventional pulmonology; Neumología intervencionista; Reducción endoscópica del volumen pulmonar; Reducción endoscópica del volumen pulmonar con espiral