Clinical Features, Outcomes, and Predictors of Recurrence in Patients Treated with Bronchial Arterial Embolization Using a Gelatin Sponge to Control Hemoptysis

Abstract

Objective: The clinical features and outcomes of bronchial arterial embolization (BAE) for hemoptysis were investigated, and we aimed to identify the factors associated with recurrent hemoptysis after BAE. Patients and Methods: Thirty-three consecutive patients treated with BAE for hemoptysis between July 2011 and June 2018 in a single medical center were retrospectively analyzed. Sex, age, body mass index, smoking history, comorbidity, laboratory data, etiology, angiographic findings, number and variety of embolized vessels, adverse events, and outcomes were evaluated. Results: The median age at the time of first BAE was 71 years (interquartile range [IQR], 59.5-86.5 years). The most common etiologies were cryptogenic hemoptysis (n=6), non-tuberculosis mycobacteriosis (n=6), pulmonary aspergillosis (n=5), bronchiectasis (n=5), and others (n=11). The common angiographic findings were neo-vascularization (n=31) and hypertrophied vessels (n=19). Eight patients (24%) experienced recurrence after BAE during the median follow-up time of 15 months (IQR, 4-25.5 months), and recurrence occurred in two patients (6%) within 1 month and in one patient (3%) after 3 years. The recurrence-free time after BAE was significantly shorter in patients with !20 pack-years smoking history (p=0.0218) and patients using anticoagulants or antiplatelet agents (p=0.0032). No moderate to severe adverse events related to BAE were encountered. Conclusion: BAE is a safe and effective treatment to control hemoptysis. However, recurrence occurred in 24% of our patient series. A smoking history of !20 pack-years and the use of anticoagulants or antiplatelet agents may be associated with a higher rate of recurrent hemoptysis following BAE.