Bronchial Artery Embolization for Hemoptysis in Cystic Fibrosis Patients: A 17-Year Review

J Vasc Interv Radiol. 2020 Feb;31(2):331-335. doi: 10.1016/j.jvir.2019.08.028. Epub 2019 Dec 30.

Abstract

Purpose: To review safety and efficacy of bronchial artery embolization (BAE) for treatment of hemoptysis in adult patients with cystic fibrosis (CF) and to report 30-day, 1-year, and 3-year outcomes.

Materials and methods: Between January 2001 and April 2018, 242 patients with CF were evaluated for hemoptysis. Thirty-eight BAEs were performed in 28 patients with hemoptysis. Technical success was defined as freedom from repeat embolization and hemoptysis-related mortality. Clinical success was defined as freedom from repeat embolization and mortality from any cause. Technical and clinical success were examined at 30 days, 1 year, and 3 years after initial BAE. Mean patient age was 32 years, and median follow-up was 4.8 years (range, 10 mo to 16.7 y).

Results: Technical and clinical success rates at 30 days were 89% (25/28) and 82% (23/28), respectively. Success rates at 1 year were 86% (24/28) and 79% (22/28), respectively, and at 3 years were 82% (23/28) and 75% (21/28), respectively. The 30-day overall complication rate was 7.9% (3/38) with 2.6% (1/38) major complication rate and 5.2% (2/38) minor complication rate. Overall 3-year mortality rate was 25% (7/28).

Conclusions: BAE is safe and effective in patients with CF presenting with life-threatening hemoptysis. BAE results in high rates of long-term technical and clinical success in this patient population despite progressive chronic disease. Repeat embolization is necessary only in a minority of patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bronchial Arteries* / diagnostic imaging
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / diagnosis
  • Cystic Fibrosis / mortality
  • Databases, Factual
  • Embolization, Therapeutic* / adverse effects
  • Embolization, Therapeutic* / mortality
  • Female
  • Hemoptysis / diagnostic imaging
  • Hemoptysis / etiology
  • Hemoptysis / mortality
  • Hemoptysis / therapy*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Young Adult