Abstract
Rationale: Hemoptysis frequently develops in the clinical course of Mycobacterium avium complex (MAC) lung disease. Bronchial artery embolization (BAE) is considered as one of the useful treatments of massive and persistent hemoptysis. The aim of this study was to analyze the clinical characteristics of patients with hemoptysis associated with MAC and to evaluate efficacy and safety of BAE.
Methods: Among 529 patients who were admitted to our institute with MAC lung disease from January 2007 to December 2012, we retrospectively reviewed the background, imaging findings and clinical course of the patients who underwent BAE using coils due to hemoptysis.
Results: Forty-three patients with a median age of 72 years (ranged from 35 to 88) and male:female ratio of 9:34 were included in this study, demonstrating nodular/bronchiectasis in 27 (62.8%) and fibrocavitary pattern in 16 (37.2%) on CT scan. A median length from the initial diagnosis of MAC lung disease to BAE was 60 months and MAC was under treatment with antibiotics in 21 (48.8%) patients at the time of BAE. Non-rebleeding rate during 12 months after BAE was 79.1%. Presence of aspergilloma (p<0.01) and more than 5 vessels embolized at BAE (p<0.05) indicated a statistically significant correlation with rebleeding. When limited to 35 MAC patients without aspergilloma, non-rebleeding rate was 88.6% for 12 months. No major complications occurred.
Conclusion: BAE is an effective and safe method to control hemoptysis in patients with MAC lung disease. It is important to carefully observe the patients with risk factors for rebleeding such as aspergilloma and multiple vessels embolized at BAE.
- © 2014 ERS