Abstract
Introduction and Purpose: Hemoptysis is one of the most common symptoms in pulmonary diseases and can be life-threatening when massive because of acute blood loss. Bronchial artery embolization (BAE) provides a definite cure for hemoptysis and is associated with lower morbidity and mortality rates when compared with thoracic surgery. Nevertheless, despite favorable technical success rates with BAE, the recurrence rates after the procedure remain high. There are several reasons for recurrent hemoptysis and only a few studies have evaluated factors contributing to recurrence. The purpose of our study was to evaluate variables associated with recurrence after BAE in the management of hemoptysis.

Materials and Methods: Patients who underwent bronchial artery embolization in a tertiary center with hemoptysis were retrospectively reviewed. A total of 87 patients (64 males and 23 females; mean age 52.01 ± 15.35) were included in the study. The etiology of hemoptysis, pathologic vessels, angiographic findings, technical success, clinical success, complication, and recurrence rates were noted. The chi- square test was used to evaluate the relationship between recurrence and possible risk factors.

Results: Technical success, described as the ability to selectively embolize the pathologic vessel, was achieved in 85 patients (85/87, 97.7%), and clinical success, described as the hemoptysis-free survival of at least 30 days was achieved in 83 (83/87, 95.4%) patients. The mean follow-up period was 15.25 ±9.11 months (range 1-32 months). Recurrence was observed in 12 patients (12/87, 13.8%). None of the demographic or etiologic factors had a relationship with rebleeding. Involvement of a non-bronchial systemic artery and bronchopulmonary shunt on the angiography was associated with recurrence after a successful BAE.

Discussion and Conclusion: BAE is a useful and effective treatment method for moderate and massive hemoptysis in different kinds of diseases. However, recurrence rates remain high even after a technically successful procedure. Bronchopulmonary shunts and non-bronchial systemic artery involvement were designated as risk factors for recurrence in our study.