A retrospective analysis of risk factors in recurrent hemoptysis patients with non-bronchial systematic artery feeding

BACKGROUND: Hemoptysis is a symptom of a life-threatening condition. Bronchial artery embolization (BAE) is recommended to control hemoptysis. However, non-bronchial systematic arteries (NBSAs) can be culprit vessels, particularly in recurrent hemoptysis patients after embolization, according to recent studies. Therefore, the purpose of the present study was to retrospectively assess the risk factors of recurrent hemoptysis patients with NBSA feeding after interventional embolization. METHODS: Between January 2014 and December 2017, a total of 545 patients underwent interventional embolization for hemoptysis. A total of 93 patients who were confirmed to have NBSA feeding and underwent embolization were enrolled. Patients’ demographic characteristics, clinical information, laboratory tests, imaging findings, and embolization outcomes were reviewed. The Kaplan-Meier method and logistic regression analysis were performed for recurrence-free survival rates and risk factors associated with rebleeding, respectively. RESULTS: Clinical success was achieved in 40.9% (9/22) of patients who underwent embolization prior to computed tomography (CT) bronchial arteriography (BA), and in 98.6% (70/71) of patients who underwent CTBA first. The median follow-up duration was 511 days (range, 1–1,539 days). CTBA performed after the first embolization (P<0.001) and elevated pre-embolization C-reactive protein (P<0.05) were associated with hemoptysis recurrence in multivariate regression analyses. CONCLUSIONS: Multidetector CTBA was recommended prior to embolization, as it shows the diagnostic value for detecting NBSA. Elevated pre-embolization C-reactive protein was found to be associated with rebleeding after embolization.