title: Bronchial artery embolization to control hemoptysis in patients with Mycobacterium avium complex.
abstract: BACKGROUND
  Hemoptysis frequently develops in patients with Mycobacterium avium complex (MAC) pulmonary disease. Bronchial artery embolization (BAE) has been established as one of the useful treatments of massive and persistent hemoptysis. We evaluated the efficacy and safety of BAE for controlling hemoptysis in MAC patients, and identified the risk factors of rebleeding after BAE.
  
  
  METHODS
  Among the 529 patients with MAC who were admitted to our institution from January 2007 to December 2012, we retrospectively reviewed the demographic data, imaging, sputum, and angiographic findings, and the clinical course of 43 patients who underwent BAE using coils, due to hemoptysis.
  
  
  RESULTS
  Among the 43 patients enrolled in the study, rebleeding developed in 13 cases (30.2%) with a mean follow-up period of 18 months. Median rebleeding-free time after BAE was 29.9 months and the cumulative hemoptysis control rates were 79.1%, 73.8%, and 63.3% in one, two, and three years, respectively. Rebleeding-free time significantly correlated with comorbid chronic pulmonary aspergillosis (CPA). When limited to 35 MAC patients without CPA, the rate increased to 88.6%, 82.1%, and 70.4%, respectively. Factors such as coexisting CPA, multiple embolized vessels at BAE, longer length of time from the diagnosis of MAC to BAE, and an administration of antibiotics for MAC at the time of hemoptysis, indicated statistically significant correlations with rebleeding. Major complications concerning BAE were not encountered.
  
  
  CONCLUSIONS
  BAE using coils is an effective and safe method for controlling hemoptysis in patients with MAC pulmonary disease. However, it is important to carefully observe patients with risk factors for rebleeding after BAE.
authors.affiliation: Center for Respiratory diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. Electronic address: rgjyc340@ybb.ne.jp.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Okuda
authors.affiliation: Center for Respiratory diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. Electronic address: kimihiko-in@tokyo-hosp.jp.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Masuda
authors.affiliation: Center for Respiratory diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. Electronic address: mkawashima-in@tokyo-hosp.jp.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kawashima
authors.affiliation: Center for Respiratory diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. Electronic address: takaandou-tky@umin.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ando
authors.affiliation: Center for Respiratory diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. Electronic address: d.er.leier@hotmail.co.jp.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Koyama
authors.affiliation: Center for Asthma and Allergy, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. Electronic address: ohshima-in@tokyo-hosp.jp.
authors.forename: Nobuharu
authors.initials: N
authors.lastname: Ohshima
authors.affiliation: Center for Respiratory diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. Electronic address: tamura-in@tokyo-hosp.jp.
authors.forename: Atsuhisa
authors.initials: A
authors.lastname: Tamura
authors.affiliation: Center for Respiratory diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. Electronic address: hnagai-in@tokyo-hosp.jp.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nagai
authors.affiliation: Center for Respiratory diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. Electronic address: bob-in@tokyo-hosp.jp.
authors.forename: Shinobu
authors.initials: S
authors.lastname: Akagawa
authors.affiliation: Center for Respiratory diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. Electronic address: hmatui-in@tokyo-hosp.jp.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Matsui
authors.affiliation: Center for Respiratory diseases, National Hospital Organization Tokyo National Hospital, Tokyo, Japan; Center for Asthma and Allergy, National Hospital Organization Tokyo National Hospital, Tokyo, Japan. Electronic address: kenohta@tokyo-hosp.jp.
authors.forename: Ken
authors.initials: K
authors.lastname: Ohta
mesh_terms: D000368:Aged; D001981:Bronchial Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006469:Hemoptysis / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Bronchial artery embolization; Chronic pulmonary aspergillosis; Hemoptysis; Mycobacterium avium complex