Objective: The clinical features and outcomes of bronchial arterial embolization (BAE) for hemoptysis were investigated, and we aimed to identify the factors associated with recurrent hemoptysis after BAE.

Patients and Methods: Thirty-three consecutive patients treated with BAE for hemoptysis between July 2011 and June 2018 in a single medical center were retrospectively analyzed. Sex, age, body mass index, smoking history, comorbidity, laboratory data, etiology, angiographic findings, number and variety of embolized vessels, adverse events, and outcomes were evaluated.

Results: The median age at the time of first BAE was 71 years (interquartile range [IQR], 59.5-86.5 years). The most common etiologies were cryptogenic hemoptysis (n=6), non-tuberculosis mycobacteriosis (n=6), pulmonary aspergillosis (n=5), bronchiectasis (n=5), and others (n=11). The common angiographic findings were neo-vascularization (n=31) and hypertrophied vessels (n=19). Eight patients (24%) experienced recurrence after BAE during the median follow-up time of 15 months (IQR, 4-25.5 months), and recurrence occurred in two patients (6%) within 1 month and in one patient (3%) after 3 years. The recurrence-free time after BAE was significantly shorter in patients with ≥20 pack-years smoking history (p=0.0218) and patients using anticoagulants or antiplatelet agents (p=0.0032). No moderate to severe adverse events related to BAE were encountered.

Conclusion: BAE is a safe and effective treatment to control hemoptysis. However, recurrence occurred in 24% of our patient series. A smoking history of ≥20 pack-years and the use of anticoagulants or antiplatelet agents may be associated with a higher rate of recurrent hemoptysis following BAE.

We report our initial experience with embolization of a splenic artery aneurysm in a woman in her 50s using the combination of large-diameter, hydrogel-coated detachable coils and a large-bore, high-flow microcatheter. The 20-mm diameter splenic artery aneurysm was packed densely with 10 hydrogel-coated coils, and the volume embolization ratio after full hydrogel expansion was 50.7%, a strikingly high value. Excellent occlusion was achieved with a small number of hydrogel-coated coils, which yield high volumes. This procedure can reduce the need for retreatment.

In this report, we present the case of a patient with recurrent stomal variceal bleeding treated with partial splenic artery embolization (PSE). The patient, a woman in her 60s, had a history of liver cirrhosis and underwent ileocecal resection for ascending colon carcinoma 6 months earlier. The bleeding did not respond to local treatment. Balloon-occluded retrograde transvenous obliteration (BRTO) was performed via the right superficial epigastric vein. However, gross stomal variceal bleeding recurred 2 months post-BRTO. PSE was therefore performed and satisfactory results were obtained. To the best of our knowledge, this is the first case of recurrent hemorrhage from stomal varices that was successfully treated with PSE in a patient with portal hypertension. We consider PSE to be a minimally invasive and definitive treatment for recurrent stomal variceal bleeding.