Bronchial Artery Embolization for Hemoptysis: A Retrospective Single-Center Study

Background: Hemoptysis is a potentially life-threatening respiratory emergency that requires prompt evaluation and management. Bronchial artery embolization (BAE) is currently regarded as the first-line treatment for massive and recurrent hemoptysis because of its high technical and clinical success rates, minimally invasive nature, and favorable safety profile. The aim of this retrospective study was to evaluate the technical and clinical outcomes of bronchial artery embolization in patients presenting with hemoptysis, including procedure-related complications and recurrence during follow-up. Methods: A single-center, retrospective, observational study was conducted. Thirty-five consecutive adult patients (37 procedures) who underwent BAE for hemoptysis between January 2018 and April 2026 were identified. Immediate outcomes were analyzed in all patients, whereas follow-up outcomes were analyzed in the 30 patients (32 procedures) with available follow-up data. Clinical, imaging, procedural, and follow-up data were collected from electronic medical records and the Picture Archiving and Communication System (PACS). Technical success (per procedure) was defined as embolization of all angiographically identified target arteries with achievement of the angiographic endpoint, and clinical success (per patient) as complete cessation or significant reduction in hemoptysis within 48 h after the index BAE, sustained until discharge; persistent bleeding or rebleeding before discharge was classified as clinical failure. Recurrence of hemoptysis was assessed separately during follow-up and was defined as any new episode of hemoptysis occurring after discharge in patients with initial clinical success, regardless of severity or the need for repeat embolization. Results: Technical success was achieved in all 37 procedures (100%) and clinical success in 34/35 patients (97.1%); the remaining patient underwent successful repeat BAE during the index hospitalization. Procedure-related adverse events occurred after 2/37 procedures (5.4%) and consisted of transient chest pain due to non-target embolization of Onyx into intercostal branches (CIRSE grade 1); no major complications occurred. In the 30 patients with follow-up (median 14.6 months), recurrent hemoptysis occurred in 3 (10.0%), all within the first year, and one (3.3%) required repeat BAE. Conclusions: In this single-center retrospective series, BAE, performed predominantly with liquid embolic agents, was associated with high technical and clinical success and a low rate of minor procedure-related complications. These findings are descriptive and hypothesis-generating. Because of the retrospective design, small sample size, attrition, heterogeneous etiologies, and absence of a comparator group, no conclusions on comparative effectiveness can be drawn. Larger prospective multicenter studies are needed.