Korean J Radiol.  2010 Oct;11(5):542-546. 10.3348/kjr.2010.11.5.542.

Comparison of the Effectiveness of Embolic Agents for Bronchial Artery Embolization: Gelfoam versus Polyvinyl Alcohol

• Hahn S
• Kim YJ
• Kwon W
• Cha SW
• Lee WY

• KMID: 1102579
• DOI: http://doi.org/10.3348/kjr.2010.11.5.542

Abstract

OBJECTIVE
The purpose of this study was to compare the results of different agents for bronchial artery embolization of hemoptysis.
MATERIALS AND METHODS
From March 1992 to December 2006, a bronchial artery embolization was performed on 430 patients with hemoptysis. The patients were divided into three groups. Group 1 included 74 patients treated with a gelfoam particle (1x1x1 mm), while group 2 comprised of 205 patients treated with polyvinyl alcohol (PVA) at 355-500 micrometer, and group 3 included 151 patients treated with PVA at 500-710 micrometer. We categorized the results as technical and clinical successes, and also included the mid-term results. Retrospectively, the technical success was compared immediately after the procedure. The clinical success and mid-term results (percentage of patients who were free of hemoptysis) were compared at 1 and 12 months after the procedure, respectively.
RESULTS
Neither the technical successes (group 1; 85%, 2; 85%, 3; 90%) nor the clinical successes (group 1; 72%, 2; 74%, 3; 71%) showed a significant difference among the 3 groups (p > 0.05). However, the mid-term results (group 1; 45%, 2; 63%, 3; 62%) and mid-term results excluding the recurrence from collateral vessels in each of the groups (group 1; 1 patient, 2; 4 patients, 3; 2 patients) showed that group 1 was lower than the other two groups (p < 0.05). No significant difference was discovered for the mid-term results between groups 2 and 3. Moreover, the same results not including incidences of recurrence from collateral vessels also showed no statistical significance between the two groups (p > 0.05).
CONCLUSION
Polyvinyl alcohol appears to be the more optimal modality compared to gelfoam particle for bronchial artery embolization in order to improve the mid-term results. The material size of PVA needs to be selected to match with the vascular diameter.

Keyword

Hemoptysis; Bronchial artery embolizationv; Gelfoam; Polyvinyl alcohol

MeSH Terms

Adolescent
Adult
Aged
Angiography
*Bronchial Arteries
Embolization, Therapeutic/*methods
Female
Gelatin Sponge, Absorbable/*therapeutic use
Hemoptysis/etiology/radiography/*therapy
Hemostatics/*therapeutic use
Humans
Male
Middle Aged
Polyvinyl Alcohol/*therapeutic use
Treatment Outcome

Figure

• 

  Fig. 1 39-year-old male with hemoptysis in right lower lobe. A. Bronchial angiography showed bleeding from right bronchial artery which originated from intercostobronchial trunk. B. After embolization with 2-Fr microcatheter, follow-up bronchial angiography showed no evidence of bleeding in right bronchial artery.

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  Fig. 2 Cumulative hemoptysis-free rates for each group.

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