Superselective bronchial artery embolization for hemoptysis with a coaxial microcatheter system.
OBJECTIVE
To compare the effectiveness and safety of superselective bronchial artery embolization with that of nonsuperselective embolization in the control of hemoptysis.


METHODS
Retrospective case analysis was done for 47 patients with hemoptysis originating from a variety of causes. In 22 patients, embolization was performed superselectively using a microcatheter inserted into the bronchial artery beyond the spinal or mediastinal branches (superselective group). In the remaining 25 patients, embolization was performed at the opening of the bronchial artery with a 5-F catheter (nonsuperselective group).


RESULTS
Initial hemoptysis control rates were 96% (21 of 22) in the superselective group and 88% (22 of 25) in the nonsuperselective group. Cumulative hemoptysis control rates of the superselective and nonsuperselective groups were 80% and 67% at 6 months, 79% and 56% at 1 and 2 years, and 79% and 48% at 3 years, respectively (not significant; generalized Wilcoxon test). One major complication (spinal infarction) occurred in the nonsuperselective group.


CONCLUSIONS
Superselective embolization is safer and more effective way to control hemoptysis than the ordinary (nonsuperselective) method.
Tanaka
N
N
Department of Radiology, Mie University, School of Medicine, Japan.
Yamakado
K
K
Murashima
S
S
Takeda
K
K
Matsumura
K
K
Nakagawa
T
T
Takano
K
K
Ono
M
M
Hattori
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D001981:Bronchial Arteries / Q000000981:diagnostic imaging; D002404:Catheterization; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006469:Hemoptysis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome