Efficacy and safety of treating acute hemoptysis using glue embolization: A retrospective observational study and comparison to the literature

Abstract

Abstract Objective A retrospective observational study of the short-term efficacy and safety of using glue embolization, namely n-butyl-2-cyanoacrylate (NBCA), in bronchial artery embolization (BAE) and comparison with the literature. The main aim of the study is to display the safety of this embolic material through standardization of interventional procedure for consideration of NBCA as a possible primary embolic agent in cases of BAE. Material-and-Methods A total of 37 BAE were performed in 33 patients with acute hemoptysis after failure of bronchoscopic therapy using NBCA. The mean age was 56 years with 22 male patients. Pre-interventional bronchoscopy and CTA were performed. In 35 cases, embolization was performed exclusively with NBCA. One patient in combination with coils and one with particles and coils. The 1:4 NBCA-to-Lipiodol mixture was most commonly used. Post-interventional bronchoscopy was performed after 24 hours. Results Technical success was possible in all cases. Clinical success was achieved in 94.6%. The mortality rate from hemorrhagic shock was 5.4%. A minor complication of temporary ischemia of the bronchial mucosa. No major complications. No reperfusion of the embolized vessel, however with rebleeding in four patients from different primarily not embolized bronchial arteries. Conclusion Despite previous concerns about its safety based on previous reports and in line with recent studies, we conclude that NBCA is a safe and effective embolic agent to perform BAE in cases of acute hemoptysis if performed according to a clear standard operating procedure as described with a possible superiority over embolic agents. Further blinded prospective comparative studies are necessary.