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 em- bolized 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 recur- rence after BAE during the median follow-up time of 15 months (IQR, 4-25.5 months), and recurrence oc- curred 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.