Superselective bronchial artery embolization for hemoptysis with a coaxial microcatheter system

PURPOSE: To compare the effectiveness and safety of superselective bronchial artery embolization with that of nonsuperselective embolization in the control of hemoptysis. MATERIALS AND METHODS: Retrospective case analysis was done for 47 patients with hemoptysis originating from a variety of causes, In 22 patients, embolization was performed superselectively using a microcatheter inserted into the bronchial artery beyond the spinal or mediastinal branches (superselective group), In the remaining 25 patients, embolization was performed at the opening of the bronchial artery with a 5-F catheter (nonsuperselective group). RESULTS: Initial hemoptysis control rates were 96% (21 of 22) in the superselective group and 88% (22 of 25) in the nonsuperselective group, Cumulative hemoptysis control rates of the superselective and nonsuperselective groups were 80% and 67% at 6 months, 79% and 56% at 1 and 2 years, and 79% and 48% at 3 years, respectively (not significant; generalized Wilcoxon test), One major complication (spinal infarction) occurred in the nonsuperselective group. CONCLUSIONS: Superselective embolization is a safer and more effective way to control hemoptysis than the ordinary (nonsuperselective) method.