Ignasi Garcia-Olivé1, José Sanz-Santos2, Carmen Centeno3, Joaquim Radua4, Felipe Andreo5, Jaume Sampere6, Josep Maria Michavila6, Jordi Muchart6, Zoran Stojanovic3, Juan Ruiz Manzano7. 1. 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. 2. 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. 3. Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España. 4. Departmento de Estadística, FIDMAG Research Unit, Sant Boi de Llobregat, Barcelona, España; CiberSam - Ciber de Salud Mental, Madrid, España. 5. 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. 6. Servicio de Radiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España. 7. 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.
Abstract
INTRODUCTION: 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. MATERIAL AND 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). CONCLUSION: 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.
INTRODUCTION: 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. MATERIAL AND 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). CONCLUSION: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.