Comparison of n-Butyl-2-Cyanoacrylate and Tris-Acryl Microspheres for Bronchial Artery Embolization in Patients with Cystic Fibrosis and Hemoptysis: A Retrospective Cohort Study.

PURPOSE: To compare the effectiveness and safety of bronchial artery embolization using n-butyl-2-cyanoacrylate (nBCA) versus tris-acryl microspheres in patients with cystic fibrosis.

MATERIALS AND

METHODS

Fifty-eight patients with severe hemoptysis (>100 mL/24 h) who underwent endovascular embolization between June 2019 and July 2024 were retrospectively analyzed. Patients were divided into 2 subgroups based on the embolic agent used: nBCA (n = 38) and tris-acryl microspheres (n = 20). Technical success, primary and secondary clinical success, safety, and recurrence rates were evaluated. Potential predictors of recurrence-including the number of pathological arteries identified on computed tomography (CT) angiography, the number and caliber of treated vessels, laterality, and embolized vascular district (bronchial vs nonbronchial systemic arteries)-were assessed using appropriate univariate tests.

RESULTS

Technical success was achieved in all procedures. Primary clinical success was obtained in 57 of 58 patients (98.3%). During follow-up (mean, 42.9 months [SD ± 12.3]), recurrence occurred in 10 of 58 patients (17.2%), with a significantly higher relapse rate in the microsphere group (10 of 20, 50%) and no recurrences in the nBCA group (0 of 38) (P = .0005). Most recurrences (7 of 10) originated from nonbronchial systemic arteries previously embolized with microspheres. No major adverse events were observed. No other variable-including age, number of pathological arteries on CT angiography, vessel caliber, or laterality-showed a significant association with recurrence.

CONCLUSIONS

nBCA was associated with lower recurrence rates compared with tris-acryl microspheres. Most relapses arose from nonbronchial systemic arteries. Further studies with larger cohorts are needed to confirm these findings and to evaluate additional factors influencing outcomes.