Systemic arterial embolization in patients with hemoptysis: initial experience with ethylene vinyl alcohol copolymer in 15 cases.
OBJECTIVE
The purpose of this study was a preliminary evaluation of the use of ethylene vinyl alcohol copolymer to treat patients with hemoptysis of systemic arterial origin.


METHODS
We reviewed the cases of 15 consecutively registered patients (10 men, five women; mean age, 53.7 years) who underwent endovascular administration of ethylene vinyl alcohol copolymer in the management of hemoptysis. The indications, immediate control of hemoptysis, and clinical tolerability were analyzed.


RESULTS
The indications for embolization were mainly early recurrence of hemoptysis with reperfusion of systemic arteries in seven cases; unstable microcatheter in two cases; large ectopic bronchial artery in two cases; and, in one case each, bronchial arterial bleeding through a small anastomotic network, aneurysm of the left internal thoracic artery in a patient with invasive aspergillosis, a potentially risky connection between the bronchial and right coronary arteries, and occlusion of a systemic artery due to Pryce type 1 intralobar lung sequestration. Hemoptysis was controlled in all but one case and did not recur in the other 14 cases. The injection procedure was well tolerated.


CONCLUSIONS
Ethylene vinyl alcohol copolymer embolization for hemoptysis of systemic arterial origin is feasible. The agent seems beneficial in the care of patients with recurrent hemoptysis after previous bronchial arterial embolization, patients who would be at high risk during embolization with microparticles, and patients who need embolization of large systemic arteries through small-caliber anastomoses.
Khalil
Antoine
A
Department of Radiology, Tenon Hospital, and Pierre et Marie Curie University, 4 Rue de la Chine, 75020 Paris, France. antoine_khalil@yahoo.fr
Fartoukh
Muriel
M
Bazot
Marc
M
Parrot
Antoine
A
Marsault
Claude
C
Carette
Marie-France
MF
D000792:Angiography; D001981:Bronchial Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006469:Hemoptysis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000627:therapeutic use*; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome
D011145:Polyvinyls; C020320:ethylene-vinyl alcohol copolymer