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

Affiliations
  • 1Department of Radiology, Yonsei University Wonju College of Medicine, Gangwon-do 220-701, Korea. yjkwch@yonsei.ac.kr
  • 2Department of Internal Medicine, Yonsei University Wonju College of Medicine, Gangwon-do 220-701, Korea.

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.

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


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