Embosphere microspheres size for bronchial artery embolization in patients with hemoptysis caused by bronchiectasis: a retrospective comparative analysis of 500-750 versus 700-900 µm microspheres

Abstract

Abstract Objective: To compare the safety and efficacy outcomes of 500-750 versus 700-900 μm Embosphere microspheres for bronchial artery embolization (BAE) in patients with bronchiectasis-related hemoptysis. Methods: A retrospective review was conducted on consecutive patients with bronchiectatic hemoptysis who were scheduled to undergo BAE treatment during a period from January 2018 to December 2022. The patients received BAE using microspheres of different sizes: group A patients were treated with 500-750 μm microspheres, and group B patients were treated with 700-900 μm microspheres. The cost of embolic microspheres (Chinese Yuan, CNY), duration of hospitalization, complications, and hemoptysis-free survival were compared between patients in group A and those in group B. A Cox proportional hazards regression model was used to identify predictors of recurrent hemoptysis. Results: The final analysis included a total of 112 patients (49-77 years of age; 45 men). The patients were divided into two groups: group A (N=68), which received 500-750 μm Embosphere microspheres, and group B (N=44), which received 700-900 μm Embosphere microspheres. Except for the cost of embolic microspheres(group A,5314.8+ 1301.5 CNY; group B, 3644.5+1192.3 CNY; p=0.042), there were no statistically significant differences in duration of hospitalization (group A,7.2+1.4 days; group B, 8 +2.4days; p = 0.550), hemoptysis-free survival (group A, 1-year, 2-year, 3-year, 85.9%, 75.8%, 62.9%; group B, 1-year, 2-year, 3-year, 88.4%, 81.2%,59.4%;P=0.060), and complications(group A,26.5%; group B, 38.6%; p = 0.175) between the two groups. No major complications were observed. The multivariate analysis results revealed that the presence of cystic bronchiectasis (OR 1.61, 95% CI 1.12–2.83; P =0.001) and systemic arterial-pulmonary shunts (SPSs) (OR 1.52, 95% CI 1.10–2.72; P =0.028) were independent risk factors for recurrent bleeding. Conclusions: For the treatment of BAE in patients with bronchiectasis-related hemoptysis, 500-750 μm diameter Embosphere microspheres have a similar efficacy and safety profile compared to 700-900 μm diameter Embosphere microspheres, especially for those without SPSs or cystic bronchiectasis. Furthermore, the utilization of large-sized (700-900 µm) Embosphere microspheres is associated with the reduced cost of an embolic agent.