Clinical analysis of the efficacy of bronchial artery embolization with gelatin sponge in our hospital for cryptogenic hemoptysis: a single-center, retrospective, observational study.

BACKGROUND AND

OBJECTIVE

Hemoptysis is a life-threatening condition requiring urgent treatment. Bronchial artery embolization (BAE), established as the primary intervention, is an effective treatment for hemoptysis. Common etiologies include bronchiectasis, tumors, tuberculosis, aspergilloma, and cystic fibrosis. Approximately 20% of hemoptysis cases are categorized as cryptogenic. We conducted a retrospective observational study to understand the clinical characteristics of patients with cryptogenic hemoptysis (CH).

METHODS

The clinical characteristics, angiographic findings, and immediate and long-term efficacies of BAE were retrospectively analyzed in 36 consecutive patients between January 2010 and December 2022. Superselective BAE was successfully performed in all patients by using a gelatin sponge (GS).

RESULTS

The median age was 68 years, and 21 patients (58.3%) were male. Among them, 15 patients (41.7%) presented with massive hemoptysis, and 7 (19.4%) required intubation. Angiographic evaluation revealed the treatment of total 57 vessels, comprising 51 (89.5%) bronchial arteries, 5 (8.8%) intercostal arteries, and 1 (1.8%) inferior transverse artery. The recurrence-free rates were 100% at 1 month, 94.4% at 3 months, 94.4% at 12 months, and 86.1% at more than 12 months. Only one patient required a second BAE for hemoptysis, while others were managed for recurrences with oral hemostatic agents. No serious complications, such as spinal cord infarction, were observed during the study period.

CONCLUSION

BAE treatment with GS for CH proved to be a suitable therapeutic modality, demonstrating high efficacy in halting bleeding in both the short and long terms, with the absence of severe complications, including spinal cord infarction.

TRIAL REGISTRATION: This study was retrospectively registered for the UMIN Clinical Trial Registry (UMIN000042050) on October 8th, 2020.