Non-tumorous recurrent hemoptysis after transcatheter embolization of bronchial artery:its causes and strategy

Objective To analyze the causes of non-tumorous recurrent hemoptysis after transcatheter embolization of bronchial artery and to discuss its prevention measures.Methods Transcatheter embolization of bronchial artery was carried out in 152 patients with acute non-tumorous hemoptysis,of whom recurrent hemoptysis within one year occurred in 62,and super-selective angiography of bronchial artery and other systemic arteries were performed again,based on which embolization therapy was repeated.The initial angiography was reviewed.The relationship between the embolization material and the recurrence of non-tumorous hemoptysis was analyzed.Results Hemoptysis recurrence occurred in one week,one,6 and 12 months after embolization was seen in 12,21,36 and 62 cases,respectively.Recurrent hemoptysis in 25 patients was caused by the recanalization of Gelfoam-embolized bronchial artery.The recurrent hemoptysis in 16 patients was due to the missing embolization of diseased bronchial artery branch and in another 9 patients was due to the missing embolization of diseased systemic artery which fed the hemoptysis lesions.The newly-established collateral circulation inside the hemoptysis lesions accounted for the recurrent hemoptysis in 12 patients who had received embolization with Gelfoam particles and micro-spring coils.Conclusion To find out all feeding arteries of hemoptysis lesion,to use un-absorbable embolization particles and to occlude all the feeding arteries completely are the key points for avoiding the recurrent hemoptysis.