Bronchial artery and systemic artery embolization in the management of primary lung cancer patients with hemoptysis.
OBJECTIVE
To assess the safety and effectiveness of arterial embolization in lung cancer patients with hemoptysis.


METHODS
Nineteen primary lung cancer patients with hemoptysis underwent bronchial artery and systemic artery embolization from April 2002 to March 2005. There were 17 men and 2 women, with a mean age of 59 years. Histologic analysis revealed squamous cell carcinoma in 10 patients and poorly differentiated adenocarcinoma in 9 patients. The amount of hemoptysis was bleeding of 25-50 ml within 24 hr in 8 patients, recurrent blood-tinged sputum in 6, and bleeding of 100 ml or more per 24 hr in 5. Embolization was done with a superselective technique using a microcatheter and polyvinyl alcohol particles to occlude the affected vessels.


RESULTS
Arterial embolization was technically successful in all patients and clinically successful in 15 patients (79%). The average number of arteries embolized was 1.2. Bronchial arteriography revealed staining (all patients), dilatation of the artery or hypervascularity (10 patients), and bronchopulmonary shunt (6 patients). The recurrence rate was 33% (5/15) and 11 patients were alive with a mean follow-up time of 148 days (30-349 days).


CONCLUSIONS
Arterial embolotherapy for hemoptysis in patients with primary lung cancer is an effective, safe therapeutic modality despite the fact the vascular changes are subtle on angiography.
Park
Hong Suk
HS
Research Institute and Hospital, National Cancer Center Korea, Ilsan-gu, Goyang-si, Gyeonggi-do, 411-764, Korea. hpark@ncc.re.kr
Kim
Young Il
YI
Kim
Hyae Young
HY
Zo
Jae-Ill
JI
Lee
Joo Hyuk
JH
Lee
Jin Soo
JS
D000230:Adenocarcinoma / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D001980:Bronchi / Q000098:blood supply*; D001999:Bronchoscopy; D002294:Carcinoma, Squamous Cell / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D006469:Hemoptysis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D008175:Lung Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013895:Thoracic Arteries / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome