Effectiveness of Bronchial Artery Embolization in the Management of Malignant Hemoptysis: A Single Institution Experience

To evaluate the technical success and clinical effectiveness of bronchial artery embolization (BAE) in the management of malignancy-related hemoptysis.  

Materials and Methods:

A retrospective analysis of all BAE procedures performed at a single tertiary center over a 10-year period between January 2013 and December 2023 was performed. Rates of technical success, clinical success, complication, need for repeat embolization, and overall survival were calculated from patient chart review.  

Results:

A total of 43 patients had a BAE for malignant hemoptysis at our institution within the study period. 88.4% (38/43) of these had a pathological diagnosis of primary lung malignancy, with the remaining being due to metastatic lung disease. Technical success was reported in all cases. Clinical success rate was achieved in 76.7% (33/43) of patients. Total complication rate was 4.6% (2/43) with one patient suffering a minor complication (inconsequential dissection of bronchial artery) and another patient suffering a major complication (non-targeted embolization leading to cord ischemia). Three patients (7.0%) required repeat embolization within 30 days. Eight patients (18.6%) died during the same hospital admission, 7 of which were due to respiratory arrest related to ongoing hemoptysis. Median overall survival was 107.5 days following BAE, with a six-month survival rate of 40.0%.

Conclusion:

BAE is a safe, technically feasible, and clinically effective option for the management of malignancy-related hemoptysis, despite the high rate of post-procedural all-cause mortality due to patient’s clinical status and terminal illness.