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How to control the fatal hemoptysis problem through minimally invasive interventional technology?
Hemoptysis is a serious health problem caused by respiratory tract bleeding and poses a major threat to the patient's life. Minimally invasive interventional technology, namely Bronchial Artery Embolization (BAE), is gradually becoming an effective method to treat this disease. The goal of this surgery is to control hemoptysis caused by bronchial arteries or other blood vessels and reduce the risk of recurrent bleeding by a static approach. With the advancement of technology, the safety and effectiveness of BAE have been significantly improved, and it has obviously become the current gold standard for the treatment of hemoptysis.
The basic principle of bronchial artery embolization is to stop bleeding caused by pathological channels through embolization of bronchial arteries.
BAE surgery uses catheter intervention to inject embolic materials (such as gelatin sponge and polyvinyl alcohol, etc.) into the bleeding blood vessels to stop the blood flow. Studies show that the success rate of hemostasis after surgery can reach more than 90%. However, this ratio has certain variability due to different underlying diseases affecting hemostatic effect.
Indications for treatment
Currently, BAE has good efficacy in treating hemoptysis caused by various causes, including bronchiectasis, non-tuberculous mycobacterial infection, pneumonia and tuberculosis. When targeting hemoptysis caused by lung cancer, the effect of BAE is more complicated, because embolism of the tumor's blood supply artery may cause more severe bleeding, which requires professional treatment strategies. According to the Japanese study, the number of hemoptysis patients submitted for BAE treatment is still small, mainly due to the lack of relevant facilities and experience.
BAE is not a panacea for all hemoptysis, and a reasonable treatment plan still needs to be developed based on the cause.
Operation technical details
In BAE surgery, the doctor will choose to insert a catheter with a diameter of less than 2mm through the femoral artery or radial artery. The catheter is inserted into the bronchial artery or other blood vessels related to hemoptysis under image guidance, thereby performing high-precision embolization. During the operation, the patient is usually under local anesthesia, and the entire operation takes about 1 to 3 hours. At this time, the blood vessels will be carefully observed to ensure that the selected embolization point is correct.
Effectiveness evaluation
With the advancement of treatment technology and equipment, BAE has become a long-term treatment for hemoptysis. Although past studies have shown that BAE is mainly used in palliative care, new results show that it can significantly improve the hemostatic effect and patient quality of life. Based on follow-up of cases, the long-term effects of BAE can last for several years in certain cases.
Research shows that BAE can significantly improve patients' quality of life, especially in terms of physical and mental health.
Selection of embolic materials
The embolization materials used in BAE operations mainly include polyvinyl alcohol (PVA), new medical instant adhesive (NBCA), gelatin sponge, metal coils, etc. Each of these materials has its own advantages and indications. For example, N-based PVA performs well in bleeding control, while the use of NBCA is highly praised for its rapid embolization and low complication rate. However, different materials may show significant differences in reducing the risk of rebleeding and improving patient survival.
Possible complications and solutions
Although the safety profile of BAE continues to improve, there is still a risk of complications, such as chest pain or, rarely, vertebral artery insufficiency. Recent studies have proven that microcatheter technology for super-selective BAE can significantly reduce the probability of spinal ischemia. In theory, any medical procedure may involve risks, and doctors need to conduct a comprehensive assessment of the patient's health status before performing surgery.
Summary
BAE represents a minimally invasive solution that offers new hope for patients with hemoptysis. Although the current application of this therapy still faces regional resource allocation challenges, as the technology matures and medical facilities are enhanced, we may be able to see more patients benefit from this technology in the future. Can humans find the best solution to combat hemoptysis in this evolving medical field?
