16 - Selective Bronchial Artery Coil Embolization (sBACE): An Alternative to Particle Embolics

Monday, March 31, 2025

12:10 PM – 1:10 PM CT

Location: Music City Center, Expo Poster Area

Poster Presenter(s)

Norbert Kuc, MD

Resident Physician
Montefiore Medical Center, United States

Author/Co-author(s)

KW

Kapil Wattamwar, MD

Interventional Radiology Fellow
Montefiore Medical Center, United States
JS

Jesse Schwalb, MD

Resident
Montefiore Medical Center, United States
Jacob Cynamon, MD, FACR, FSIR

Attending
Montefiore Medical Center, United States

Purpose: Bronchial artery embolization (BAE) is the established first line treatment for massive hemoptysis. The procedure carries an inherent risk of spinal cord infarction and paralysis secondary to inadvertent off-target embolization of a non-visualized spinal artery. In the USA, BAE is generally performed using particle embolics, with limited data on coil embolization {1}. Coil embolization was suggested to have a lower rate of spinal cord infarction compared to particle embolics, presumably due to the preservation of collateral flow associated with more proximal coil-only embolization {2,3}. After a significant particle BAE injury at this institution, a protocol for coil-only BAE was developed. The purpose of this study is to describe a single-center’s experience performing a consecutive series of selective bronchial artery coil-only embolization and to determine the procedure’s feasibility and effectiveness.

Materials and Methods: A retrospective review was performed of all selective bronchial artery coil embolizations (sBACE) performed at a single institution. Patients who received simultaneous particle or liquid embolic were excluded. Six patients were identified (median age: 52, 50% female). All patients presented with massive hemoptysis. Three of 6 (50%) patients had hemoptysis secondary to tuberculosis, and 3/6 (50%) of patients had hemoptysis secondary to anticoagulation. Procedural, imaging, and medical record data were reviewed for procedure data and patient outcomes.

Results: sBACE was successfully performed in all (6/6) patients with resolution of hemoptysis. A median of 2.5 (range 2-8) coils were used for embolization. Packing coils were used in 6/6 procedures. Mean follow up period was 121 days (range 7-286). No patient required additional intervention for symptomatic hemoptysis. There were no complications associated with the procedure.

Conclusion: sBACE is effective at providing durable hemostasis for patients experiencing massive hemoptysis. With increasing prevalence of the use of superselective microcatheters and improved coil technology, coil-only embolization may be comparable in effectiveness to particle embolization. The increased operator controllability of coil embolization and reduced risk of off-target embolization or occult embolic reflux may result in a lower risk of spinal cord infarction with sBACE compared to particle embolics.