Abstract No. 448 Bronchial artery embolization for hemoptysis in cystic fibrosis patients

Abstract

Over the past 20 years, there has been significant improvement in the treatment of cystic fibrosis (CF), which has prolonged survival from the second decade, well into the fourth decade of life. We sought to evaluate short, medium, and long-term outcomes of bronchial artery embolization (BAE) in this population. Between January 2001 and April 2018, 242 patients with cystic fibrosis presented to our institution with hemoptysis. Thirty-eight BAEs were performed on 28 patients. Outcomes were examined at 30 days, 1 year, and 3 years and reported as technical success rates (no repeat embolization or death from hemoptysis) and clinical success rates (no repeat embolization or death from any cause). Thirty-day complication and overall mortality rates were evaluated. Mean patient age for BAE was 32 years old and median follow up was 4.8 years (range 10 months to 16.7 years). Within 30 days, short-term technical and clinical success rates were 89.3% (25/28 patients) and 82.1% (23/28) respectively; three patients had repeat embolization, 1 patient died of hemoptysis, and 1 patient died of multiorgan system failure. One year technical and clinical success rates were 85.7% (24/28) and 78.6% (22/28); an additional patient had repeat embolization at 44 days and again at 7 months. The 3-year technical and clinical success rates were 82.1% (23/28) and 75% (21/28); an additional patient had repeat embolization at 1 year 10 months. The thirty-day complication rate was 10.5% (4/38 BAEs) and included a death due to massive hemoptysis 2 hours after BAE, femoral artery access site thrombosis, transient chest pain, and transient odynophagia. Overall 3-year mortality rate was 25% (7/25). BEA is a safe and effective procedure with low complication rates and is a potentially life saving intervention. BEA has high long-term technical and clinical success rates for controlling hemoptysis in cystic fibrosis patients. Repeat embolization is necessary in some patients.