title: Long-term effect of bronchial artery embolization in Korean patients with haemoptysis.
abstract: OBJECTIVE
  Bronchial artery embolization (BAE) has been regarded as a bridging therapy in the management of massive haemoptysis until a more definite therapy can be pursued. The long-term effectiveness of BAE and the factors associated with failure to control bleeding in an Asian setting of tuberculosis are unknown and were investigated.
  
  
  METHODS
  Over approximately 4 years, 139 patients received BAE to treat haemoptysis at a single centre, of these, 118 had been followed up for more than 1 year (median 23 months) and were retrospectively recruited into the study. Patients were divided into those who required readmission for treatment of recurrent haemoptysis after BAE (re-bleeding group), and those who did not (non-rebleeding group).
  
  
  RESULTS
  Of the 118 patients, 112 (95.8%) had haemoptysis of greater than 100 mL per day. The most common underlying cause of haemoptysis was pulmonary tuberculosis. Eight patients, four of whom had advanced lung cancer, died after BAE. There were 32 patients (27.1%) in the re-bleeding group. Aspergillosis was significantly associated with re-bleeding after BAE (P<0.05). There were no differences in gender, age, degree of haemoptysis, or APACHE II scores between the re-bleeding and non-rebleeding groups. Twelve patients in the re-bleeding group had a repeat BAE only, whereas seven underwent surgery after repeat BAE. Of the 118 patients who underwent initial BAE, one showed a transient spinal ischaemia.
  
  
  CONCLUSIONS
  BAE with appropriate medical treatment should be sufficient for most patients with massive haemoptysis. In patients with massive haemoptysis due to aspergilloma, however, elective surgery should be considered if bleeding is not controlled by repeated BAE.
authors.affiliation: Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Yong Gil
authors.initials: YG
authors.lastname: Kim
authors.forename: Hyun-Ki
authors.initials: HK
authors.lastname: Yoon
authors.forename: Gi Young
authors.initials: GY
authors.lastname: Ko
authors.forename: Chae-Man
authors.initials: CM
authors.lastname: Lim
authors.forename: Won Dong
authors.initials: WD
authors.lastname: Kim
authors.forename: Younsuck
authors.initials: Y
authors.lastname: Koh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001228:Aspergillosis / Q000150:complications; D001981:Bronchial Arteries / Q000503:physiopathology*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006469:Hemoptysis / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D007723:Korea; D008172:Lung Diseases, Fungal / Q000150:complications; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D013997:Time Factors; D016896:Treatment Outcome