Multidetector computed tomography angiography findings predicts the need for bronchial artery embolization for moderate to severe hemoptysis: a single-center retrospective cohort study

Background: While the utility of multidetector computed tomography angiography (MDCTA) as a guide before bronchial artery embolization (BAE) has been demonstrated, its utility in determining the need for BAE is unclear. In the present study, we investigated whether MDCTA could identify the need for BAE in patients with moderate to severe hemoptysis. Methods This single-center retrospective cohort study included 32 patients with moderate to severe hemoptysis > 100 mL/day requiring hospitalization from April 1, 2012 to March 31, 2015. The relationship between MDCTA findings and the need for BAE was analyzed. Results MDCTA revealed normal bronchial arteries in 14 of the 32 patients. Among the remaining 18 patients with abnormally dilated bronchial arteries, the arteries remained within the mediastinum in 6 patients and extended from the mediastinum to the pulmonary parenchyma in 12 patients. None of the six patients’ bronchial arteries that remained within the mediastinum underwent BAE, regardless of the dilation status, and hemoptysis could be controlled with conservative treatment. BAE was required in 58% (7/12) of the patients with abnormally dilated bronchial arteries extending to the pulmonary parenchyma. There was a significant association between MDCTA findings and the need for BAE (p < 0.001). Conclusions MDCTA finding of abnormally dilated bronchial artery extending from the mediastinum to the pulmonary parenchyma may predict the need for BAE in patients with moderate to severe hemoptysis.