Abstract
The aim of this study is to clarify the clinical outcome of bronchial artery embolization (BAE) for hemoptysis from pulmonary aspergilloma, in comparison with the outcome for other diseases. Fifty-six patients, 34 males and 22 females, with a median age of 70 years (range, 32–92), underwent BAE using gelatin sponge and/or glue, between April 2003 and July 2015. The etiology of hemoptysis was pulmonary aspergilloma in 9 (PA group) and other diseases in 47 (control group: bronchiectasis in 25, obsolete tuberculosis in 9, lung carcinoma in 3, and other in 10). We reviewed medical records and images, and evaluated the technical success rate, clinical success rate, and complication. Technical success was defined as the complete cessation of the target artery as confirmed by digital subtraction angiography (DSA). Clinical success was defined as the cessation of hemoptysis within 30 days of BAE. Complications associated with BAE were evaluated by physical examinations and blood tests. Complete cessation was confirmed by DSA at the end of all procedures (56/56). Therefore, the technical success rate was 100% in both groups. Nine of 47 patients in the control group, and two of 9 patients in the PA group could not be followed, and thus the clinical success was evaluated in 38 patients in the control group, and 7 in the PA group. In the control group, re-hemoptysis within 30 days was found in 6 of 38 patients, and all 6 patients underwent re-BAE. In the PA group, re-hemoptysis within 30 days was found in 6 of 7 patients. Three of the 6 patients underwent re-BAE, one was converted to lobectomy, and two died of re-hemoptysis. Therefore, the clinical success rate was 84% (32/38) in the control group, and 14% (1/7) in the PA group, with a significant difference (P < 0.05). There was no complication associated with BAE in both groups. The clinical outcome of BAE for hemoptysis from pulmonary aspergilloma was markedly worse than from other diseases.
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