A retrospective analysis of risk factors in recurrent hemoptysis patients with non-bronchial systematic artery feeding

Abstract

Background: Hemoptysis is a symptom of a life-threatening condition. Bronchial artery embolization (BAE) is recommended to control hemoptysis. However, non-bronchial systematic arteries (NBSAs) can be culprit vessels, particularly in recurrent hemoptysis patients after embolization, according to recent studies. Therefore, the purpose of the present study was to retrospectively assess the risk factors of recurrent hemoptysis patients with NBSA feeding after interventional embolization.Methods: Between January 2014 and December 2017, a total of 545 patients underwent interventional embolization for hemoptysis. A total of 93 patients who were confirmed to have NBSA feeding and underwent embolization were enrolled. Patients' demographic characteristics, clinical information, laboratory tests, imaging findings, and embolization outcomes were reviewed. The Kaplan-Meier method and logistic regression analysis were performed for recurrence-free survival rates and risk factors associated with rebleeding, respectively.Results: Clinical success was achieved in 40.9% (9/22) of patients who underwent embolization prior to computed tomography (CT) bronchial arteriography (BA), and in 98.6% (70/71) of patients who underwent CTBA first. The median follow-up duration was 511 days (range, 1-1,539 days). CTBA performed after the first embolization (P<0.001) and elevated pre-embolization C-reactive protein (P<0.05) were associated with hemoptysis recurrence in multivariate regression analyses.Conclusions: Multidetector CTBA was recommended prior to embolization, as it shows the diagnostic value for detecting NBSA. Elevated pre-embolization C-reactive protein was found to be associated with rebleeding after embolization.

Microspheres present comparable efficacy and safety profiles compared with polyvinyl alcohol for bronchial artery embolization treatment in hemoptysis patients

“…Of note, we found that offending vessels of left bronchial artery rather than right bronchial artery (vs. bilateral bronchial artery) was also an independent predictive factor for increased hemoptysis recurrence risk or mortality risk, which might be explained by that different anatomical structure. Anatomically, left BA is narrower and longer than right BA, which might increase the failure to identify culprit vessels and therefore enhance hemoptysis recurrence risk and mortality risk [ 28 ]. Furthermore, interestingly, we found that hemoptysis volume were independent predictive factors for increased hemoptysis recurrence risk or mortality risk, which might be associated with the difficulty of bleed controlling and unstable hemodynamics, increasing hemoptysis recurrence risk [ 6 ].…”

Six Cases of Hemoptysis with Angiogenesis from Non-Bronchial Systemic Arteries

“…Bronchial arteries are the most common source of hemoptysis, accounting for 90% of cases [ 3 ]. However, a variety of other systemic arteries, such as the intercostal artery, internal thoracic artery, subclavian artery, and inferior phrenic artery, can also cause hemoptysis [ 4 , 5 ]. Although non-bronchial systemic supply is a relatively well-known phenomenon, the clinical features of hemoptysis related to systemic arteries other than bronchial arteries are still potential pitfalls for successful embolization.…”