Clinical observation of interventional treatment by occluders in 13 children with hemoptysis

Abstract:

Objective：To analyze the interventional diagnosis and treatment of 13 children with hemoptysis and to improve the skills of pediatricians in the diagnosis and treatment of hemoptysis in children. Methods：The medical records including clinical manifestations，laboratory results，image data and treatments of 13 pediatric patients with hemoptysis given interventional treatment were retrospec－tively reviewed. Results：In 13 patients，including pneumonia（10 cases） and anaemia（9 cases），digital subtraction angiography（DSA） was performed for 21 times，and artery embolization therapy was performed for 14 times. Siderophages were identified in 7 patients. Four patients had massive hemoptysis，and 9 patients had non-massive hemoptysis. Five patients with collateral vessels were identified by ultrasonic cardiogram before interventional diagnosis，and 9 patients were identified by computed tomography angiography（CTA）. Thirty-two abnormal pulmonary vessels were detected by DSA. Twenty-five（78.125%） of them were aberrant bronchial arteries，and seven of （21.875%） them arose from non-bronchial systemic arteries. Conventional treatments，including hemostatic agents，oxygen supplementation，ventilation support and hemoglobin maintaining，were administrated. Fourteen patients required bronchial artery em－bolization（BAE） treatment； the hemoptysis disappeared for all the patients three days after BAE； two of them were detected to have contract leaking to mediastinum，four of them had chest pain，one of them had complication of femoral arterial thrombosis. Conclusion：Echocardiography（UCG） combining CTA plays significant role in screening of pediatric hemoptysis suspecting to be aberrant vessels，and DSA is the golden standard for diagnosis. Occluder em－bolizing aberrant vessels has good effect of hemostasis. Aberrant vessel embolization by occluder has high quality in hemostasis，safety and stability，which is worth popularizing.