Bronchial and Nonbronchial Systemic Artery Embolization in Patients With Major Hemoptysis: Safety and Efficacy of N-Butyl Cyanoacrylate

Abstract

OBJECTIVE. The purpose of this study was to evaluate the safety and efficacy of N-butyl cyanoacrylate for bronchial and nonbronchial systemic artery embolization in the management of major hemoptysis. MATERIALS AND METHODS. From March 2004 through March 2006, 108 patients with major hemoptysis underwent embolization with N-butyl cyanoacrylate. The common conditions causing hemoptysis were bronchiectasis (n = 34), sequelae of tuberculosis (n = 31), active tuberculosis (n = 18), lung cancer (n = 8), and aspergilloma (n = 6). A retrospective analysis of postprocedure outcomes, including immediate success, recurrence of hemoptysis, cause of recurrence, and complications, was performed. RESULTS. Immediate success was achieved in 105 patients (97.2%). During the follow-up period (range, 5 days–63 months; median, 28.5 months), recurrent hemoptysis was found in 21 of the 105 patients (20%). Repeat angiograms (n = 14) revealed incomplete embolization during the initial procedure in seven patients with early recurrence (< 3 months) and revascularization of nonbronchial systemic collateral arteries in seven patients with late recurrence (> 3 months). No recanalization of embolized arteries was found on repeat angiograms or at follow-up CT. The cumulative nonrecurrence rates were 91.4% 1 month, 83.4% 1 year, 76.7% 3 years, and 56.8% 5 years after the initial procedure. The procedure-related complications included transient chest pain (n = 21) and denudation of the bronchial mucosa (n = 3), which was clinically silent but found at bronchoscopy. CONCLUSION. N-butyl cyanoacrylate is a safe and effective agent for embolization in patients with major hemoptysis.