Efficacy of bronchial artery embolization in hemoptysis: longitudinal studyon survival and recurrence

Abstract Background and objectives Managing hemoptysis can be challenging due to recurrences after different treatment methods. This study aimed to assess the efficacy and long-term outcomes of bronchial artery embolization (BAE) in controlling hemoptysis and improving patient survival. Methods In this prospective cohort study, patients with hemoptysis undergoing BAE between August 2017 and August 2022 were enrolled and prospectively followed. Clinical characteristics, underlying etiologies, complications, and post-procedural recurrences were prospectively recorded during a 1- to 4-year follow-up period. The survival for each factor was graphed in subgroups by the Kaplan–Meier (KM) curve and presented the estimation of the hazard ratio (HR) with 95% confidence interval (CI) from the univariate Cox proportional hazard (PH) model. Results A total of 297 patients (32% female, 58% with massive hemoptysis) were included. The mean survival time (MST) for all-cause mortality was 35.9 months (95% CI 33.6–38.3) and for hemoptysis-related death was 45.1 months (95% CI 43.8–46.4). The overall recurrence rate was 14.6% at 1-month post-BAE, decreased to 5.7% by the 9th month, and rose again to approximately 20% during long-term follow-up. Recurrence was significantly 71% higher in patients with non-massive hemoptysis (46.6%) compared with those with massive hemoptysis (33.8%, OR  = 1.71, 95% CI 1.05–2.80, P  = 0.03). Conclusions BAE effectively controls life-threatening hemoptysis with favorable long-term survival and acceptable recurrence rates. Optimized management of the underlying pulmonary disease may further improve BAE outcomes and reduce recurrence risk.