A retrospective analysis of 148 patients with massive hemoptysis treated by bronchial artery embolization

Abstract

Objective To analyze efficacy and security of bronchial arteriography and bronchial artery embolization. Methods The etiologies, clinical characteristics, procedure details, outcome and complication of 148 patients who had undergone bronchial artery embolization for massive hemoptysis from March 2009 to April 2016 were retrospectively analyzed. Results 148 patients underwent bronchial arteriography and bronchial artery embolization.There were 118 men and 30 women with an age range from 14 to 91 years old.Active pulmonary tuberculosis and sequelae of pulmonary tuberculosis such as fibrosis, cavitation were the major pathogeny of massive hemoptysis and were present in 83 patients.The pathogeny could not be identified in 30 patients.All relevant arteries were evaluated.These arteries that showed circuity, hypertrophy, exudation and significant blush were targeted.Bilateral bronchial arteries were the most common culprit artery (n=64), followed by right bronchial (n=53), left bronchial (n=23), and posterior intercostal artery (n=23). Gel foam was used in all patients, gel foam combinated with polyvinyl alcohol was used in 28 patients, and gel foam combinated with spring coil was used in 68 patients.Immediate control of massive hemoptysis was achieved in 120 of 148 patients.Of the remaining 25 patients with a notable amount of bleeding after the procedure, six cases were treated successfully with conservative measures and seven cases underwent re-embolization.Three patients underwent successful surgery, and one died of hemoptysis.Three patients had serious complications, including glaucoma (n=1), paraplegia (n=1) and stroke (n=1), and 63 patients had minor complications, including chest pain (n=32) and low-grade fever (n=31). Conclusions Bronchial artery embolization is a effective therapy to control massive hemoptysis.Repeat bronchial artery embolization can be performed safely, but serious complications should be valued. Key words: Hemoptysis; Angiography; Bronchial arteries; Bronchial artery embolization; Clinical characteristics