Predictors of 12-Month Recurrence of Hemoptysis after Bronchial Artery Embolization

Despite the high success rate of bronchial artery embolization (BAE), hemoptysis probably recurs. This study investigated risk factors of 12-month hemoptysis recurrence after BAE in an Iranian population.

In this prospective cohort, we followed up 101 patients for 12 months after BAE. Outcome of interest was recurrence of hemoptysis. Target arteries were super-selectively catheterized and embolized with non-spherical polyvinyl alcohol particles (150-700 µm). Success of BAE was confirmed using post-BAE angiography. Independent t-test, and chi-square and Fisher's exact test were used to compare variables between "recurrence" and "non-recurrence" groups. We investigated predictors of recurrent hemoptysis through univariate and multivariate logistic regression modeling. We analyzed receiver operating characteristic curve to find the optimal cutoff point for continuous risk factors. Recurrence-free rates stratified by risk factors were plotted against time using the Kaplan-Meier method.

BAE was immediately successful in all patients. During the 12-month follow-up, hemoptysis recurred in 13.9% (95% CI: 8.2-21.6) of participants. Mean (±standard deviation) recurrence-free time was 6.9 (±3.3) months. Lung destruction (OR=5.40 [95% CI: 1.41-20.58], P value=0.013) and arterial diameter≥2 mm (12.51 [1.51-103.59], P value=0.019) were independent predictors of 12-month hemoptysis recurrence.

Patients with destroyed lungs and embolized arteries wider than 2.0 mm are at higher risk of hemoptysis recurrence in the first year after BAE.