Bronchial Artery Embolization in Hemoptysis: 10-Year Survival and Recurrence-Free Survival in Benign and Malignant Etiologies – A Retrospective Study

• Published in: RöFo : Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebende Verfahren Vol. 188; no. 11; pp. 1061 - 1066
• Main Authors: Syha, R., Benz, T., Hetzel, J., Spengler, W., Kohlhäufl, M. J., Gatidis, S., Grözinger, G., Horger, M., Nikolaou, K., Ketelsen, D.
• Format: Journal Article
• Language: English
• Published: Stuttgart · New York Georg Thieme Verlag KG 01.11.2016
• Subjects: Adult; Aged; Brachial Artery; Disease-Free Survival; Embolization, Therapeutic - methods; Embolization, Therapeutic - mortality; Germany - epidemiology; Hemoptysis - mortality; Hemoptysis - therapy; Hemostatics - therapeutic use; Humans; Interventional Radiology; Longitudinal Studies; Lung Neoplasms - mortality; Lung Neoplasms - therapy; Middle Aged; Prevalence; Recurrence; Retrospective Studies; Risk Factors; Survival Rate; Treatment Outcome; malignant etiology; benign etiology; subgroup analysis; broncial artery embolization
• ISSN: 1438-9029; 1438-9010
• DOI: 10.1055/s-0042-112227

Abstract Purpose: The aim of the study was to evaluate safety, effectiveness, recurrence rate and 10-year survival after bronchial artery embolization (BAE) in benign and malignant etiologies. Methods: The retrospective study includes 100 BAE procedures in 88 patients. Underlying disease was classified as benign (n = 67) and malignant (n = 21) etiologies. Immediate bleeding control and procedure safety were evaluated in all patients. In 51 (58 %) patients, follow-up data with a median follow-up time of 1015 days (range, 494 to 3727 days) were acquired to assess overall survival, time-to-recurrence of bleeding and recurrence-free survival, using Kaplan-Maier estimates to compare differences between both subgroups. Results: Immediate bleeding control was achieved after 96/100 procedures (96 %), with a minor complication rate of 5.0 %. No major complications occurred. The overall survival was 74 % after 1 year and 59 % after 5 years and 10 years. There was a significant difference in survival between the malignant and benign groups (p < 0.0001). Survival was 90 %, 80 % and 76 % at 1 year, 3 years and 10 years, respectively, in the benign group and 18 % and 0 % at 1 year and 3 years, respectively in the malignant group. The median time to recurrence of bleeding and recurrence-free survival were 239 days and 94 % after 1 year and 87 % after 10 years in the benign group, compared to 66 days and 34 % after 1 year and 0 % after 3 years in the malignant group (p = 0.0107). Conclusion: BAE is a safe and highly effective treatment option in hemoptysis. However, the recurrence rate and survival are highly dependent on the underlying disease. Key Points: • BAE is a safe and highly effective treatment option in hemoptysis. • Recurrence rate and survival are strongly dependent on the underlying disease with significantly impaired results in patients with malignant diseases. • Coil embolization is an effective BAE treatment method. Nevertheless, it should be mentioned, that reinterventions can be impeded, if embolization is performed in the proximal part of bronchial arteries. Citation Format: • Syha R, Benz T, Hetzel J et al. Bronchial Artery Embolization in Hemoptysis: 10-Year Survival and Recurrence-Free Survival in Benign and Malignant Etiologies – A Retrospective Study. Fortschr Röntgenstr 2016; 188: 1061 – 1066