MR assessment of shunt fraction in CF patients before and after BAE
Research type
Research Study
Full title
A prospective pilot study: Magnetic Resonance Imaging (MRI) derived measures of bronchial arterial flow in the assessment and follow-up of patients with Cystic fibrosis (CF) who undergo bronchial artery embolisation
IRAS ID
256039
Contact name
Simon Padley
Contact email
Sponsor organisation
Royal Brompton and Harefield NHS Foundation Trust
Duration of Study in the UK
1 years, 3 months, 31 days
Research summary
As patients with cystic fibrosis (CF) advance in age the severity of their underlying chronic lung changes also progresses. One of the most troublesome and distressing clinical manifestations of these changes is coughing up fresh blood (haemoptysis).
The Royal Brompton and Harefield NHS Trust cares for over 950 patients with CF, with both its paediatric and adults centres being amongst the largest in Europe. As a result, we see a considerably higher number of patients with haemoptysis than many other CF centers.
Haemoptysis can be life threatening if large volume of blood is lost. It requires rapid evaluation and often endovascular management. Embolisation of the bronchial arteries is routinely performed to control bleeding.
Over the last 5 years we have developed a protocol whereby a patient who develops small volumes of repeated haeomptysis is admitted for semi-elective embolisation of the bronchial arteries. This is therefore done under controlled circumstances rather than as an emergency procedure.There is no doubt bronchial artery embolisation is an effective treatment for patients with severe haemoptysis. At present there are no objective radiological measures that have been able to demonstrate a deleterious effect from blocking off these bronchial arteries.
In this study we aim to formally evaluate the ratio of pulmonary blood flow through pulmonary arteries (Qp) compared to the flow through systemic (bronchial) arteries (Qs) before and after embolisation procedures. The presence of any clinical effect from this reduction in blood flow will also be evaluated with standard physiological assessment including spirometry, as well as through standard breathlessness assessment questionnaires.
We hypothesise that reduction in bronchial artery supply will have no impact on respiratory reserve and will justify our new treatment approach of semi-elective intervention in CF patients with intermittent haemoptysis.
REC name
East of England - Cambridge East Research Ethics Committee
REC reference
19/EE/0154
Date of REC Opinion
14 May 2019
REC opinion
Further Information Favourable Opinion