title: Transarterial ethylene vinyl alcohol copolymer visualization and penetration after embolization of life-threatening hemoptysis: technical and clinical outcomes.
abstract: OBJECTIVE
  This study was designed to evaluate the feasibility of using ethylene vinyl alcohol copolymer (EVAC) for bronchial artery embolization (BAE) in patients with life-threatening hemoptysis and to compare the visualization and transarterial penetration of EVAC under fluoroscopy and computed tomography (CT).
  
  
  METHODS
  Fifteen patients (mean age, 62.9 (range, 24-82) years) who were referred for life-threatening hemoptysis (27 month period) underwent BAE using EVAC. All patients had thoracic CT examination before and after BAE. Technical and clinical results were evaluated. Visibility and extent of cast penetration (graded 1-4) on fluoroscopy and postprocedure CT were assessed and compared.
  
  
  RESULTS
  BAE was feasible in all but one artery (due to spasm; n=27; 96.4%). No procedure-related complications or deaths were detected. Two patients had recurrent bleeding in the following day (13.3%). Immediate clinical success was achieved in 14 cases (93.3%) after reembolization of pulmonary artery pseudoaneurysm in one patient (mean follow-up, 43.5 (range, 14-148) days). Visibility of the cast was possible in 73.3% of patients (n=11) under fluoroscopy (mean cast penetration 1.66) and in all patients under CT (mean cast penetration 2.06). The postinjection fluoroscopic visibility in 6 of 15 (40%) patients was inferior to CT (P<0.02).
  
  
  CONCLUSIONS
  BAE with EVAC seems to be feasible and safe with immediate control of hemoptysis in most patients. The postinjection fluoroscopic visibility of EVAC under fluoroscopy was inferior to CT.
authors: Department of Radiology, CHU of Montpellier, Arnaud de Villeneuve Hospital, Montpellier, France. s-bommart@chu-montpellier.fr
authors: Sébastien
authors: S
authors: Bommart
authors: Arnaud
authors: A
authors: Bourdin
authors: Marie France
authors: MF
authors: Giroux
authors: François
authors: F
authors: Klein
authors: Antoine
authors: A
authors: Micheau
authors: Valérie Monnin
authors: VM
authors: Bares
authors: Hélène
authors: H
authors: Kovacsik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001981:Bronchial Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006469:Hemoptysis / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000627:therapeutic use*; D015641:Radiography, Interventional; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D011145:Polyvinyls; C020320:ethylene-vinyl alcohol copolymer