Long-term outcome of bronchial artery embolisation (BAE) for massive haemoptysis

Amit Adlakha, Rishi Gupta, Arun Sebastian, Paul Tait, James Jackson, Philip Ind1.

Author address: 

Department of Thoracic Medicine, Hammersmith Hospital, London, United Kingdom; Department of Radiology, Hammersmith Hospital, London, United Kingdom

Abstract: 

Background: BAE for massive haemoptysis is potentially life-saving with low short-to-medium term failure rates in previous studies. We aimed to characterise patients referred for BAE, to examine long-term treatment success and identify risk factors for requiring repeat BAE. Methods: We retrospectively identified all patients undergoing BAE from 1994- 2007.We collated data from hospital databases and primary care on demographics, respiratory diagnoses and procedure with follow-up of up to 16 years. Outcomes were all-cause mortality and recurrence of haemoptysis requiring repeat BAE. Results: 158 patients were embolised on 208 occasions. 85 (54%) patients were male and median age was 54 (IQR: 41-67)y. The most common underlying diagnoses were aspergilloma (n=38; 24% of patients), bronchiectasis (n=24; 15%), unidentified cause (n=17; 11%) chronic tuberculosis (n=14; 9%), active tuberculosis (n=12; 8%) and cystic fibrosis (n=11; 7%). All-cause mortality at 1 month and 3 years was 5.3% and 29.7%, and need for repeat BAE was 4.7% and 30.7% respectively. Repeat BAE at 3 years was most common with aspergilloma (50%) and least common with active TB (0%). 3-year mortality was highest in cystic fibrosis (40%) and least with unknown cause (7.7%) Neither number nor location of vessels embolised predicted mortality or need for repeat BAE. No major procedural complications were noted. Conclusions: BAE by experienced operators is a safe, minimally invasive procedure for massive haemoptysis with excellent short-term success. It does not prevent late recurrence of haemoptysis nor obviate the need for repeat BAE, the risk of which is related to the underlying disease rather than to technical aspects of the procedure.
2011

abstract No: 

P619

Full conference title: 

European Respiratory Congress
    • ERS 21st (2011)