Long-Term Outcomes of Bronchial Artery Embolization for Patients with Non-Mycobacterial Non-Fungal Infection Bronchiectasis

Respiration. 2020;99(11):961-969. doi: 10.1159/000511132. Epub 2020 Dec 2.

Abstract

Background: There is no study on the predictive factors of recurrent haemoptysis after bronchial artery embolization (BAE) with the long-term outcomes in patients with bronchiectasis (BE).

Objectives: To evaluate the long-term outcomes of BAE in BE patients without accompanying refractory active infection of mycobacteriosis and aspergillosis with analysis for the predictive factors of recurrent haemoptysis.

Methods: Data of 106 patients with BE who underwent BAE using coils between January 2011 and December 2018 were retrospectively reviewed. The cumulative haemoptysis control rate was estimated using Kaplan-Meier methods with log-rank tests to analyze differences in recurrence-free rate between groups based on technical success and failure, bacterial colonization status, number of BE lesions, and vessels embolized to bronchial arteries (BAs) or BAs + non-bronchial systemic arteries (NBSAs).

Results: Bacterial colonization was detected in approximately 60% of patients. Computed tomography showed bronchiectatic lesions with 2.9 ± 1.4 lobes. In the first series of BAE, embolization was performed in the BAs alone and BAs + NBSAs in 65.1 and 34.9% of patients, respectively, with 2.4 ± 1.4 embolized vessels in total. The median follow-up period was 1,000 (7-2,790) days. The cumulative haemoptysis control rates were 91.3, 84.2, 81.5, and 78.9% at 1, 2, 3, and 5 years, respectively. The haemoptysis control rates were higher in the technical success group than in the technical failure group (p = 0.029).

Conclusions: High haemoptysis control rates for long-term periods were obtained by embolization for all visualized abnormal arteries, regardless of the colonization status, number of bronchiectatic lobes, and target vessels, irrespective of NBSAs.

Keywords: Bronchial artery embolization; Bronchiectasis; Haemoptysis; Long-term outcomes; Technical success.

MeSH terms

  • Bronchi / diagnostic imaging
  • Bronchial Arteries / diagnostic imaging
  • Bronchial Arteries / microbiology
  • Bronchiectasis / complications
  • Bronchiectasis / microbiology
  • Bronchiectasis / therapy*
  • Computed Tomography Angiography
  • Embolization, Therapeutic*
  • Hemoptysis / etiology
  • Hemoptysis / therapy*
  • Humans
  • Kaplan-Meier Estimate
  • Recurrence
  • Retrospective Studies
  • Secondary Prevention
  • Treatment Outcome