Transcatheter arterial embolization for massive hemoptysis in patients with coal workers' pneumoconiosis: an 11-year experience.
BACKGROUND
Transcatheter arterial embolization (TAE) is a safe and well-established treatment option to control hemoptysis, but there are few studies focused on treating hemoptysis accompanying coal workers' pneumoconiosis (CWP).


OBJECTIVE
To evaluate the immediate and long-term efficacy of TAE for control of massive hemoptysis in patients with CWP, and to clarify the factors which influence the frequency of rebleeding.


METHODS
This study included 34 CWP patients with massive hemoptysis who were treated with 47 TAE sessions over the last 11 years. Immediate (within 1 month) and long-term outcomes (mean 37 months, range 1 month-11 years) were evaluated retrospectively. The relationships between the frequency of rebleeding and the type of CWP, angiographic findings, and presence of tuberculosis were evaluated.


RESULTS
The immediate success rate was 91.2% (31/34). In 23 patients (68%), hemoptysis did not recur on long-term follow-up. In eight patients who received repeated procedures for recurrent hemoptysis, bleeding was discovered in the non-bronchial systemic artery (n = 13) or bronchial artery (n = 7). The frequency of recurrent hemoptysis was higher in cases with complicated pneumoconiosis (n = 7) than in cases of the simple type (n = 1; P = 0.029). There was no statistical difference between rebleeding and angiographic findings or the presence of tuberculosis.


CONCLUSIONS
TAE is an effective treatment modality for controlling massive hemoptysis in patients with CWP. However, many non-bronchial systemic collaterals contribute to recurrent hemoptysis. Furthermore, there is a high probability of rebleeding in patients with the complicated type of CWP, and extra care must be taken in the embolization procedure.
Lee
Sang Hoon
SH
Department of Radiology, St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.
Hahn
Seong Tai
ST
Choi
Byung Gil
BG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001981:Bronchial Arteries / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic / Q000379:methods*; D005500:Follow-Up Studies; D006469:Hemoptysis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011009:Pneumoconiosis / Q000150:complications*; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis