Comparison of the effectiveness of embolic agents for bronchial artery embolization: gelfoam versus polyvinyl alcohol.
OBJECTIVE
The purpose of this study was to compare the results of different agents for bronchial artery embolization of hemoptysis.


METHODS
From March 1992 to December 2006, a bronchial artery embolization was performed on 430 patients with hemoptysis. The patients were divided into three groups. Group 1 included 74 patients treated with a gelfoam particle (1 x 1 x 1 mm), while group 2 comprised of 205 patients treated with polyvinyl alcohol (PVA) at 355-500 microm, and group 3 included 151 patients treated with PVA at 500-710 microm. We categorized the results as technical and clinical successes, and also included the mid-term results. Retrospectively, the technical success was compared immediately after the procedure. The clinical success and mid-term results (percentage of patients who were free of hemoptysis) were compared at 1 and 12 months after the procedure, respectively.


RESULTS
Neither the technical successes (group 1; 85%, 2; 85%, 3; 90%) nor the clinical successes (group 1; 72%, 2; 74%, 3; 71%) showed a significant difference among the 3 groups (p > 0.05). However, the mid-term results (group 1; 45%, 2; 63%, 3; 62%) and mid-term results excluding the recurrence from collateral vessels in each of the groups (group 1; 1 patient, 2; 4 patients, 3; 2 patients) showed that group 1 was lower than the other two groups (p < 0.05). No significant difference was discovered for the mid-term results between groups 2 and 3. Moreover, the same results not including incidences of recurrence from collateral vessels also showed no statistical significance between the two groups (p > 0.05).


CONCLUSIONS
Polyvinyl alcohol appears to be the more optimal modality compared to gelfoam particle for bronchial artery embolization in order to improve the mid-term results. The material size of PVA needs to be selected to match with the vascular diameter.
Hahn
Seok
S
Department of Radiology, Yonsei University Wonju College of Medicine, Gangwon-do, Korea.
Kim
Young Ju
YJ
Kwon
Woocheol
W
Cha
Seung-Whan
SW
Lee
Won-Yeon
WY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D001981:Bronchial Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use*; D006469:Hemoptysis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D016896:Treatment Outcome
D006490:Hemostatics; D011142:Polyvinyl Alcohol
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