Cryptogenic Hemoptysis: Effectiveness of Bronchial Artery Embolization Using N-Butyl Cyanoacrylate

Purpose: To describe angiographic findings and assess safety and effectiveness of bronchial artery embolization (BAE) with N-butyl cyanoacrylate (NBCA) in patients with cryptogenic hemoptysis (CH). Materials and Methods: Between May 2003 and March 2014, 26 patients who underwent BAE for CH were enrolled. A retrospective review was conducted for angiographic findings and clinical outcomes of BAE, including technical and clinical success, complications, and recurrent hemoptysis. Results: Selective arteriograms were abnormal in 22 patients (85%), showing hypertrophied bronchial arteries (n = 19), parenchymal hypervascularity (n = 18), and bronchial-to-pulmonary shunting (n = 8). All abnormal bronchial and nonbronchial collateral arteries (n = 36) were successfully embolized with NBCA. Hemoptysis ceased within 24 hours in all patients. There were no procedure-related complications. During 11-117 months of follow-up (median, 60.2 mo), 1 patient (4%) experienced recurrent hemoptysis at 5 months after initial BAE, which was treated with repeat BAE The 5-year hemoptysis-free survival rate was 96%. Conclusions: Bronchial arteries were angiographically abnormal in most patients with CH (85%). BAE is a safe and effective treatment with excellent short- and long-term results in patients with CH. NBCA appears to be a useful embolic material for this application.