Bronchial Artery Embolization for Hemoptysis Due to Benign Diseases: Immediate and Long-Term Results

Cardiovasc Intervent Radiol. Sep-Oct 2000;23(5):351-7. doi: 10.1007/s002700010062.

Abstract

Purpose: To clarify the immediate effect and long-term results of bronchial artery embolization (BAE) for hemoptysis due to benign diseases and the factors influencing the outcomes.

Methods: One hundred and one patients (aged 34-89 years) received bronchial artery embolization with polyvinyl alcohol particles and gelatin sponge for massive or continuing moderate hemoptysis caused by benign pulmonary diseases and resistant to medical treatment.

Results: After BAE, bleeding stopped in 94 patients (94%). The immediate effect was unfavorable in cases where feeder vessels were overlooked or the embolization of the intercostal arteries was insufficient. Long-term cumulative hemoptysis nonrecurrence rates after the initial embolization were 77.7% for 1 year and 62.5% for 5 years. In bronchitis (n = 9) and active tuberculosis (n = 4) groups, an excellent (100%) 5-year cumulative nonrecurrence rate was obtained. The rate was lower in groups with pneumonia/abscess/pyothorax (n = 8) or with pulmonary aspergillosis (n = 9) (53.3%, 1-year cumulative nonrecurrence). There were higher incidences of early recurrence among patients with massive hemorrhage or more marked vascularity and systemic artery-pulmonary artery shunt in angiography: however, these trends were not statistically significant

Conclusions: BAE can yield long-term benefit in patients with hemoptysis due to benign diseases. Technical problems in the procedure had an impact on the short-term effect. The degree of hemorrhage or the severity of angiographical findings were not significant factors affecting the outcome. The most significant factor affecting long-term results was whether the inflammation caused by the underlying disease was medically well controlled.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiography
  • Bronchial Arteries* / diagnostic imaging
  • Embolization, Therapeutic*
  • Female
  • Hemoptysis / diagnostic imaging
  • Hemoptysis / etiology
  • Hemoptysis / therapy*
  • Humans
  • Lung Diseases / complications
  • Lung Diseases / diagnostic imaging
  • Male
  • Middle Aged
  • Postoperative Complications
  • Treatment Outcome