To evaluate the feasibility and outcomes of a standardized pathway featuring biopsy-sparing bronchoscopy with typical endoscopic signs as triggers for selective bronchial artery embolization (BAE) in pediatric BDD, addressing the gap in current management strategies.
Key Findings:
Three patients included, median age 11 years.
Two patients had typical bronchoscopic findings (define 'typical findings') and were classified as confirmed BDD.
One patient was classified as highly suspected BDD due to airway instability.
All patients showed unilateral bronchial artery abnormalities on selective angiography.
Computed tomography angiography (CTA) failed to identify vascular lesions in all cases.
Immediate hemostasis achieved after superselective embolization with no major complications.
No recurrence observed during follow-up (3–36 months).
Interpretation:
A standardized pathway emphasizing biopsy-sparing bronchoscopy and early BAE is feasible and safe for managing pediatric BDD, yielding favorable short-term outcomes even when CTA is non-localizing, with implications for improving clinical practice.
Limitations:
Small sample size with only three patients.
Retrospective nature of the study limits generalizability and introduces potential biases.
Lack of long-term data on outcomes beyond 36 months.
Conclusion:
The study supports a biopsy-sparing approach in pediatric BDD management, highlighting the importance of early intervention through BAE and its potential impact on pediatric care.
Cross-sectional NHANES analysis found associations between select folate markers and self-reported physician-diagnosed lung cancer, though the direction and clinical significance of the relationship remain unclear
