Prognosis of Bronchial Artery Embolization in the Management of Hemoptysis

Abstract

Background: Bronchial artery embolization (BAE) is a well-accepted and widely used treatment modality for the management of massive and recurrent hemoptysis. However, few reports have previously investigated the long-term results. Objectives: To investigate the prognosis of patients with hemoptysis who had undergone BAE. Methods: Twenty-two patients with hemoptysis underwent BAE. The underlying diseases included bronchiectasis in 9, aspergillosis in 3, chronic bronchitis in 2, idiopathic bronchial bleeding in 4, and other diseases in 4. The follow-up period ranged from 25 to 88 months (median 47 months). Results: After the initial BAE, 11 of 22 (50%) patients had re-bleeding (5 patients with hemoptysis and 6 patients with minor hemosputa). Among them, 1 patient suffered from recurrent massive hemoptysis and died from airway obstruction within 1 month after BAE. In addition, 10 of these 11 (90.9%) patients experienced recurrent airway bleeding within 3 years after BAE. Recurrent cases of hemoptysis were seen in 6 of 22 patients (27.3%) within 3 years and no case recurred later than 3 years after BAE. A recurrence of hemoptysis was frequently seen in patients with either bronchiectasis or pulmonary-bronchial artery (P-B) shunt. Although BAE is an effective treatment for the immediate control of hemoptysis, 5 of the patients experienced recurrent bleeding in the long-term follow-up. Conclusions: It is important to follow-up such patients until 3 years after initial BAE, especially when either ectatic changes of the bronchi on a CT scan or a P-B shunt on angiographic findings are detected.

Safety of bronchial arterial embolization with n-butyl cyanoacrylate in a swine model

“…In histological specimens, the presence of NBCA-Lp was fulfilled as a cast, whereas GSPs were dispersed in the vessels. These results support the clinical findings that the frequency of recurrent hemoptysis was 23%-33% after embolization with GSPs [8,22] and/or PVA particles, and 10%-16.6% after NBCA-Lp embolization [8,14] . Histological examination of the lungs revealed no pulmonary infarction.…”

Massive Hemoptysis: An Update on the Role of Bronchoscopy in Diagnosis and Management

“…Patients seemed to fare better when tuberculosis, bronchitis or bronchiectasis were responsible for the massive hemoptysis [4]. In a recent study, however, bronchiectasis as an underlying cause was associated with a higher rate of recurrence of hemoptysis in a series of patients treated by BAE [48]. In cancer patients, non-tumor-related hemoptysis was associated with better survival in comparison with tumor-related bleeding, following endovascular management [49].…”

Coronary Artery Bypass Grafting in a Patient with Unstable Angina Pectoris and Bronchiectasis

“…TAE is a well accepted and widely used treatment modality for the management of massive and recurrent hemoptysis. 4) Spinal infarction due to invisible anastomotic connections between the bronchial circulation and the anterior spinal artery is the most important complication of bronchial artery embolization (BAE). To lower the incidence of spinal cord injury, superselective BAE is performed using a microcatheter inserted into the bronchial arteries beyond the spinal or mediastinal branches.…”