Transcatheter artery embolization for hemoptysis in patients with destroyed lung: risk factors for recurrence

Abstract

Background

Transcatheter arterial embolization (TAE) is an established treatment of hemoptysis in patients with destroyed lung.

Purpose

To identify the relevant risk factors for the recurrence of hemoptysis after TAE in patients with destroyed lung combined with hemoptysis.

Material and Methods

A retrospective analysis was performed on 179 patients with destroyed lung and hemoptysis who underwent TAE between January 2014 and September 2023. Immediate and clinical success rates were assessed after TAE. Kaplan–Meier analysis estimated hemoptysis-free survival. The Cox regression model was used to identify factors associated with recurrence.

Results

Among 179 patients (124 men, 55 women; mean age = 57.24 ± 12.30 years), immediate and clinical success rates were 92.2% and 89.5%, respectively. Freedom from hemoptysis at 24 h was achieved in 91.5% of patients. Cox regression analysis identified the average number of embolized vessels per damaged lobe as an independent predictor of recurrence (hazard ratio [HR] = 1.346, 95% confidence interval [CI] = 1.001–1.810; P <0.05). Patients with ≥4 embolized vessels per lobe had a significantly higher risk of recurrence than those with fewer vessels. Non-bronchial systemic arteries (NBSAs), particularly intercostal and subclavian artery branches, were key bleeding sources, with the ratio of NBSAs to bronchial arteries (BAs) embolized being approximately 1.38:1.

Conclusion

Although meticulous attention to NBSAs during TAE is essential, our study identifies the average number of embolized vessels per lobe as an independent predictor of recurrence. This indicates a disease state with high revascularization potential, necessitating long-term strategies that also address the underlying lung pathology.