Bronchial and nonbronchial systemic artery embolization in patients with major hemoptysis: safety and efficacy of N-butyl cyanoacrylate.
OBJECTIVE
The purpose of this study was to evaluate the safety and efficacy of N-butyl cyanoacrylate for bronchial and nonbronchial systemic artery embolization in the management of major hemoptysis.


METHODS
From March 2004 through March 2006, 108 patients with major hemoptysis underwent embolization with N-butyl cyanoacrylate. The common conditions causing hemoptysis were bronchiectasis (n = 34), sequelae of tuberculosis (n = 31), active tuberculosis (n = 18), lung cancer (n = 8), and aspergilloma (n = 6). A retrospective analysis of postprocedure outcomes, including immediate success, recurrence of hemoptysis, cause of recurrence, and complications, was performed.


RESULTS
Immediate success was achieved in 105 patients (97.2%). During the follow-up period (range, 5 days-63 months; median, 28.5 months), recurrent hemoptysis was found in 21 of the 105 patients (20%). Repeat angiograms (n = 14) revealed incomplete embolization during the initial procedure in seven patients with early recurrence (< 3 months) and revascularization of nonbronchial systemic collateral arteries in seven patients with late recurrence (> 3 months). No recanalization of embolized arteries was found on repeat angiograms or at follow-up CT. The cumulative nonrecurrence rates were 91.4% 1 month, 83.4% 1 year, 76.7% 3 years, and 56.8% 5 years after the initial procedure. The procedure-related complications included transient chest pain (n = 21) and denudation of the bronchial mucosa (n = 3), which was clinically silent but found at bronchoscopy.


CONCLUSIONS
N-butyl cyanoacrylate is a safe and effective agent for embolization in patients with major hemoptysis.
Department of Radiology, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-Gu, Seongnam, Gyeonggi-do, 463-707 Bundang, Korea.
Dong Hyun
DH
Yoo
Chang Jin
CJ
Yoon
Sung-Gwon
SG
Kang
Charles T
CT
Burke
Jae Ho
JH
Lee
Choon-Taek
CT
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001027:Aortography; D001228:Aspergillosis / Q000453:epidemiology; D001981:Bronchial Arteries / Q000002:abnormalities / Q000000981:diagnostic imaging; D001987:Bronchiectasis / Q000453:epidemiology; D015984:Causality; D015897:Comorbidity; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006469:Hemoptysis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013348:Subclavian Artery / Q000000981:diagnostic imaging; D014376:Tuberculosis / Q000453:epidemiology; D055815:Young Adult
D004659:Enbucrilate