Embolization for Hemoptysis in Pulmonary Aspergillosis: Effectiveness and Risk Factors for Recurrence

To evaluate the characteristics and effectiveness of embolization for hemoptysis due to pulmonary aspergillosis and analyze the risk factors for recurrence.

This retrospective cohort study evaluated 158 consecutive patients, including 117 males and 41 females with a median age of 60 years (range,18-84 years), who underwent transarterial embolization (TAE) for aspergillosis-related hemoptysis. The rate of absence of recurrent hemoptysis was calculated via Kaplan-Meier analysis, with univariate and multivariate Cox regression to analyze the risk factors for recurrence.

Among patients with aspergillosis-related hemoptysis in this cohort, 77% had comorbid bronchiectasis. TAE achieved a 93% clinical success rate, with postprocedural chest pain and fever constituting the predominant adverse events. The rates of absence of recurrent hemoptysis at 1, 3, 6, 12, 24, and 36 months after TAE were 93%, 82%, 77%, 69%, 58%, and 57%, respectively. Multivariate Cox analysis identified pulmonary cavities (P = .006), bronchiectasis (P = .027), and embolization-required inferior phrenic artery (IPA) (P = .026) as independent predictors of recurrence.

TAE is safe and effective in treating aspergillosis-related hemoptysis. IPA that required embolization independently predicted recurrence of hemoptysis, and nonvascular predictors of recurrent hemoptysis were pulmonary cavity and bronchiectasis.