Predictors of recanalization in patients with life-threatening hemoptysis requiring artery embolization.
BACKGROUND
Artery embolization (AE) is a safe and useful procedure in the management of massive hemoptysis. The objective of our study was to describe the experience of AE in a tertiary referral center, to characterize angiographic findings at the time of recurrence, and to analyze factors associated with these findings.


METHODS
Observational retrospective study of patients presenting with life-threatening hemoptysis. All consecutive patients with at least one episode of hemoptysis that required AE during a 13-year period were included. The effects of i)time to recurrence; ii)use of coils, and iii)number of arteries embolized on the likelihood that the recurrence was secondary to recanalization were assessed.


RESULTS
One hundred seventy-six patients were included in the study. Twenty-two patients (12.5%) died due to hemoptysis. Probability of recurrence-free survival at one month was 0.91 (95%CI: 0.87 to 0.95), at 12months was 0.85 (95%CI: 0.79 to 0.91), and after 3 years was 0.75 (95%CI: 0.66 to 0.83). A longer time to recurrence was associated with a higher probability that the hemorrhage affected the same artery (estimate=0.0157, z-value=2.41, p-value=0.016).


CONCLUSIONS
AE is a safe and useful technique in the management of massive and recurrent hemoptysis. Nevertheless, recurrence after embolization is not uncommon. Recurring hemoptysis due to recanalization is related to time to recurrence, but not to the use of coils or number of arteries embolized.
Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; CibeRes - Ciber de Enfermedades Respiratorias, Bunyola, Mallorca, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España. Electronic address: ignasi.g.olive@gmail.com.
Ignasi
I
Garcia-Olivé
Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España.
José
J
Sanz-Santos
Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
Carmen
C
Centeno
Departmento de Estadística, FIDMAG Research Unit, Sant Boi de Llobregat, Barcelona, España; CiberSam - Ciber de Salud Mental, Madrid, España.
Joaquim
J
Radua
Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; CibeRes - Ciber de Enfermedades Respiratorias, Bunyola, Mallorca, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España.
Felipe
F
Andreo
Servicio de Radiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
Jaume
J
Sampere
Servicio de Radiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
Josep Maria
JM
Michavila
Servicio de Radiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
Jordi
J
Muchart
Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
Zoran
Z
Stojanovic
Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; CibeRes - Ciber de Enfermedades Respiratorias, Bunyola, Mallorca, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, España.
Juan
J
Ruiz Manzano
D001027:Aortography; D001981:Bronchial Arteries / Q000000981:diagnostic imaging; D001987:Bronchiectasis / Q000150:complications; D002199:Capillary Permeability; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000706:statistics & numerical data; D005260:Female; D005339:Fibrin Foam / Q000627:therapeutic use; D006469:Hemoptysis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D011656:Pulmonary Emphysema / Q000150:complications; D015641:Radiography, Interventional; D012008:Recurrence; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects; D062606:Tertiary Care Centers
D005339:Fibrin Foam
Bronchial artery embolisation; Embolización arterial bronquial; Haemoptysis; Hemoptisis; Recidiva; Recurrence