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

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.