Bronchial artery embolization for hemoptysis due to benign diseases: Immediate and long-term results

Purpose: To clarify the immediate effect and long-term results of bronchial artery embolization (BAE) for hemoptysis due to benign diseases and the fa ctors influencing the outcomes. Methods: One hundred and one patients (aged 34-89 years) received bronchial artery embolization with polyvinyl alcohol particles and gelatin sponge fo r massive or continuing moderate hemoptysis caused by benign pulmonary dise ases and resistant to medical treatment. Results: After BAE, bleeding stopped in 94 patients (94%). The immediate ef fect was unfavorable in cases where feeder vessels were overlooked or the e mbolization of the intercostal arteries was insufficient. Long-term cumulat ive 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 tuberc ulosis (n = 4) groups, an excellent (100%) 5-year cumulative nonrecurrence rate was obtained. The rate was lower in groups with pneumonia/abscess/pyot horax (n = 8) or with pulmonary aspergillosis (n = 9) (53.3%, 1-year cumula tive nonrecurrence). There were higher incidences of early recurrence among patients with massive hemorrhage or more marked vascularity and systemic a rtery-pulmonary artery shunt in angiography: however, these trends were not statistically significant Conclusions: BAE can yield long-term benefit in patients with hemoptysis du e to benign diseases. Technical problems in the procedure had an impact on the short-term effect. The degree of hemorrhage or the severity of angiogra phical findings were not significant factors affecting the outcome. The mos t significant factor affecting long-term results was whether the inflammati on caused by the underlying disease was medically well controlled.