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. Objectives: The study was conducted to determine the incidence of bleeding complications after LVRC treatment, to identify risk factors and to discuss treatment options in cases of not spontaneously resolving hemoptysis. Methods: Retrospective observational study on all subjects in whom LVRC treatment was performed in our department between 1 April 2012 and 31 March 2015. Results: During the study period, 90 LVRC procedures were performed in 55 subjects. Early post-procedural bleeding was encountered in 64.4% of cases. Hemoptysis was significantly more likely to occur in patients on acetylsalicylic acid (p=0.006). Hemoptysis resolved spontaneously in 98.3% of cases. In the one case (1.7%) with persistent hemoptysis, bronchial artery embolization was successful to terminate the bleeding. Hospital stay was significantly prolonged in subjects with hemoptysis (p=0.01). There was no significant difference between subjects with or without hemoptysis concerning the occurrence of an exacerbation of COPD within four weeks of LVRC treatment (p=0.31). Late bleeding complications were observed in three subjects (5.5%). In two of these subjects, bronchial artery embolization was performed successfully terminating the bleeding. 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 terminate the bleeding.