Threatening hemoptysis. Results of therapy by means of arterial embolization

Objective. Retrospective analysis the immediate and long-term efficacy of e mbolization of bronchial and systemic arteries in the treatment of threaten ing or relapsing hemoptysis. Materials and methods. During the study period 122 arterial embolizations w ere performed in patients with hemoptysis over 100 ml in 24 hours, relapsin g hemoptysis and/or presence of vital risk factors. Embolization was perfor med with polyvinyl alcohol particles, spongostan and metallic spirals. Seve nty patients were included in the study and 47 were excluded as they came f rom other institutions. Results. Angiographic changes were observed in 100% of patients. The immedi ate clinical success, defined as hemoptysis control, was obtained in the 70 patients. The mean follow-up time was 21.2 +/- 16.3 months. Relapsing hemo ptysis occurred in 17.1% of patients (12 patients), of which 5.7% (4 cases) occurred in the first seven days and in 11.4% (8 patients) after 6 months. In five patients (7.1%) a new embolization was performed and 6 were operat ed after embolization (5 of them with bronchiectasis), The remarkable compl ications derived from the procedure included self-limited paraparesis of th e lower limbs and severe chest pain. Conclusions. The embolization of bronchial arteries is an efficient techniq ue for the treatment of threatening hemoptysis and relapses, is associated with a low morbidity rate, and the late relapse is relatively common among patients with bronchiectasis.