Two ways of bronchial artery embolization for various types of phthisic hemoptysis

Objective To analyze the relationship of two ways of bronchial artery embolization (BAE) with their effect on different types of phthisic hemoptysis and to study the corresponding optimal way of embolization.Methods 50 patients with secondary phthisic hemoptysis treated by BAE from May,2012 to May,2014 were selected.Among them,28 were treated by the combined embolization of polyvinyl alcohol (PVA) particles and coils and 22 only used PVA particles.15 and 12 cases of chronic fibro-cavitative type,13 and 10 cases of invasive type,21 and 14 cases of recurrent type,7 and 8 cases of initially-treated type,18 and 14 cases of single lung multiple bronchi(＞2 bronchi) offending vessel-related type,and 10 and 8 cases of single lung single bronchus offending vessel-related type were treated by combined embolization or single embolization,respectively.All patients were followed up for 1 to 3 years.The relationship of two different ways of embolization and hemoptysis types with curative effect was investigated.Results 50 patients achieved prompt hemostasis,accounted for 100.0％ (50/50).The overall efficacy (cured + effective) was 78.0％ (39/50).The recurrence rate was 22.0％ (11/50).The overall efficacies for combined embolization of PVA particles and coils and single embolization of PVA alone were 92.9％ (26/28) and 59.1％ (13/22),respectively.There was a statistical difference in effectiveness between combined and single embolization (P＜0.05).Combined embolization had significantly better curative effect (P＜0.05) than single embolization in the treatment of chronic fibro-cavitative,recurrent,and single lung multiple bronchi offending vessel-related hemoptysis.However,in regard to invasive,initially-treated,and single lung single bronchus offending vessel-related hemoptysis,there were no statistical differences between combined and single embolization (P＜0.05).Conclusions BAE is a rapid,effective,minimally invasive,and safe way in the treatment of phthisic hemoptysis and it can adapt to a variety of indications.BAE has been widely applied in clinical practice.Rational selection of embolic materials and embolization methods basing on hemoptysis types is able to further improve the efficacy.