Causes of Recurrence after Transcatheter Embolization Therapy in Hemoptysis

Objective To investigate the causes and preventions of recurrence in hemoptysis after transcatheter bronchial artery embolization (TBAE). Materials and Methods Fifty-six patients with hemoptysis were treated with TBAE. The related diseases included bronchiectasis (n=38), pulmonary tuberculosis (n=7), pulmonary carcinoma (n=6), pulmonectomy (n=4) and bronchial arteriovenous malformation (n=1). The amount of hemoptysis was 150～700 ml. In the total 56 cases, 79 target arteries were embolized, of which gelatin sponge particles (GSP) alone was used in 41, GSP together with silk thread in 4, GSP plus ethanol in 3, GSP with PVA in 4 and only PVA in 4. All the patients were followed up for over one year. DSA exam and TBAE were repeated in the recurrent patients. Results In all the patients, the hemoptysis was stopped completely in 1/2～4 hours after the procedure. At one week, 1, 6 and 12 months after TBAE, hemoptysis recurred in 7, 10, 12 and 13 cases, respectively. The causes of recurrence included reopening of the embolized bronchial artery (n=5), missing embolization of diseased bronchial artery (n=3), non-bronchial feeding artery (n=3) and deterioration of the primary disorders (n=2). The main measures to prevent recurrence of hemoptysis were as follows: (1) using GSP together with long-term embolic agents; (2) making great effort to search the lesion's feeding arteries, including phrenic, intercostal, intrathoracic, etc. arteries; (3) enhancing the treatment of the primary diseases.Conclusion A knowledge of the causes of recurrence in hemoptysis after embolization treatment is of great help for its prevention.