Bronchial Artery Embolization in Hemoptysis: 10-Year Survival and Recurrence-Free Survival in Benign and Malignant Etiologies – A Retrospective Study

Abstract

Purpose: The aim of the study was to evaluate safety, effectiveness, recurrence rate and 10-year survival after bronchial artery embolization (BAE) in benign and malignant etiologies. Methods: The retrospective study includes 100?BAE procedures in 88 patients. Underlying disease was classified as benign (n?=?67) and malignant (n?=?21) etiologies. Immediate bleeding control and procedure safety were evaluated in all patients. In 51?(58?%) patients, follow-up data with a median follow-up time of 1015 days (range, 494 to 3727 days) were acquired to assess overall survival, time-to-recurrence of bleeding and recurrence-free survival, using Kaplan-Maier estimates to compare differences between both subgroups. Results: Immediate bleeding control was achieved after 96/100 procedures (96?%), with a?minor complication rate of 5.0?%. No major complications occurred. The overall survival was 74?%?after 1 year and 59?% after 5 years and 10?years. There was a significant difference in survival between the malignant and benign groups (p?<?0.0001). Survival was 90?%, 80?% and 76?% at 1 year, 3 years and 10?years, respectively, in the benign group and 18?% and 0?% at 1 year and 3 years, respectively in?the malignant group.?The median time to recurrence of bleeding and recurrence-free survival were 239 days and 94?% after 1 year and 87?% after 10 years in the benign group, compared to 66 days and 34?% after 1 year and 0?% after 3 years in the malignant group (p?=?0.0107). Conclusion: BAE is a safe and highly effective treatment option in hemoptysis. However, the recurrence rate and survival are highly dependent on the underlying disease. Key Points: ??BAE is a safe and highly effective treatment option in hemoptysis. ??Recurrence rate and survival are strongly dependent on the underlying disease with significantly impaired results in patients with malignant diseases. ??Coil embolization is an effective BAE treatment method. Nevertheless, it should be mentioned, that reinterventions can be impeded, if embolization is performed in the proximal part of bronchial arteries. Citation Format: ??Syha R, Benz T, Hetzel J et?al. Bronchial Artery Embolization in Hemoptysis: 10-Year Survival and Recurrence-Free Survival in Benign and Malignant Etiologies ? A Retrospective Study. Fortschr R?ntgenstr 2016; 188: 1061???1066

Bronchial Artery Embolisation for Massive Haemoptysis: Immediate and Long-Term Outcomes—A Retrospective Study

“…Their results also demonstrated that disease free survival is significantly longer with benign compared to malignant causes of haemoptysis. However, long term haemoptysis free survival in the benign group can be affected by conditions such as cystic fibrosis which is associated with poor long-term survival and relatively high recurrence of haemoptysis [12,27]. Yoo et al found a 5-year haemoptysis free recurrence rate of 43.2% following primary BAE which is again comparable to our results of 43.8% [11].…”

“…There are few studies which provide at least a 5 year follow up for patients, with overall survival for our cohort being 55.8% (survival range 0-181 months). Syha et al found a similar overall survival at 5 years (59%) which remained stable at 10 years following BAE [12]. Their results also demonstrated that disease free survival is significantly longer with benign compared to malignant causes of haemoptysis.…”

“…The literature has generally focussed on the short-term outcomes of primary BAE, with only a limited number of studies having followed up patients for at least 5 years in cohorts of greater than 50 patients following successful BAE [11][12][13][14]. The aim of this retrospective study is to add to the current literature by providing the efficacy of BAE in ceasing haemoptysis, its effects on in-hospital survival and medium and long-term overall and haemoptysis-free survival in a large cohort of patients at a single UK centre.…”

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

“…BAE has been established as a minimally invasive therapy of choice for recurrent and massive hemoptysis [3] and is now recognized as the first-line treatment for controlling hemoptysis [13]. Over the past 7 years, our hospital has performed BAE for 33 hemoptysis patients.…”

“…Hemoptysis is a potentially life-threatening emergency situation requiring immediate diagnosis and therapy [1][2][3]. Based on the patient's condition, the potential treatments include conservative treatment, bronchoscopic intervention, bronchial artery embolization (BAE), and surgery [4][5][6].…”