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Early versus delayed bronchial artery embolization for non-massive hemoptysis

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Abstract

Objectives

The aims of this study were to compare clinical outcomes of early versus delayed bronchial artery embolization (BAE) for non-massive hemoptysis and to investigate predictors of recurrent hemoptysis.

Methods

From March 2018 to February 2021, 138 consecutive patients (age, 65.5 ± 12.4 years; male, 67.4%) with non-massive hemoptysis underwent BAE. The enrolled patients were divided into an early embolization (EE) group (within the first 24 h, n = 79) and a delayed embolization (DE) group (n = 59).

Results

The time to embolization ranged between 0 and 15 days and was shorter in the EE group (0.47 ± 0.5 days) than in the DE group (4.02 ± 2.8 days, p < 0.001). The in-hospital clinical outcomes were not different between the two groups, except for hospital stay and post-embolization hospital stay. The recurrence-free survival in the EE group was significantly better than that in the DE group (p = 0.018). The time to embolization (hazard ratio (HR), 1.21; 95% confidence interval (CI), 1.04–1.42; p = 0.015) and aspergilloma (HR, 6.89; 95% CI, 2.08–22.86; p = 0.002) were predictive factors for recurrent hemoptysis.

Conclusions

BAE is an effective and safe treatment modality for non-massive hemoptysis. An early interventional strategy should be considered in patients presenting with non-massive hemoptysis to reduce the length of hospital stay and early recurrence. A delayed time to embolization and the presence of aspergilloma were independent risk factors for recurrent hemoptysis.

Key Points

• Bronchial artery embolization afforded good clinical improvement for treating non-massive hemoptysis without significant complications.

• An early interventional strategy should be considered in patients presenting with non-massive hemoptysis to reduce the length of hospital stay and early recurrence.

• A delayed time to embolization and the presence of aspergilloma were independent risk factors for recurrent hemoptysis.

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Abbreviations

ACR AC:

American College of Radiology Appropriateness Criteria

BAE:

Bronchial artery embolization

CI:

Confidence interval

DE:

Delayed embolization

EE:

Early embolization

HR:

Hazard ratio

NBSC:

Non-bronchial systemic collateral

PVA:

Polyvinyl alcohol

RCT:

Randomized controlled trial

VIF:

Variance inflation factor

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Funding

This work was supported by the Soonchunhyang University Research Fund. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Sung-Joon Park and Sangjoon Lee contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan-si, Republic of Korea

    Sung-Joon Park

  2. Vascular Center, The Eutteum Orthopedic Surgery Hospital, Paju-si, Republic of Korea

    Sangjoon Lee

  3. Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan-si, Republic of Korea

    Hyoung Nam Lee

  4. Department of Radiology, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung-si, Republic of Korea

    Youngjong Cho

Authors
  1. Sung-Joon Park
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  2. Sangjoon Lee
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Corresponding author

Correspondence to Hyoung Nam Lee.

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Guarantor

The scientific guarantor of this publication is Hyoung Nam Lee.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

“Clinical Trial Center at Soonchunhyang University College of Medicine, Cheonan Hospital” kindly provided statistical advice for this manuscript.

Informed consent

Institutional review boards of all collaborating institutions approved this retrospective study and waived written informed consent for use of clinical and imaging data. Written informed consent for interventional procedures was obtained from all patients.

Ethical approval

Institutional review board approval was obtained.

Methodology

• retrospective

• observational

• performed at four institutions

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Park, SJ., Lee, S., Lee, H.N. et al. Early versus delayed bronchial artery embolization for non-massive hemoptysis. Eur Radiol 33, 116–124 (2023). https://doi.org/10.1007/s00330-022-08993-z

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  • DOI: https://doi.org/10.1007/s00330-022-08993-z

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