Comparison of n-Butyl-2-Cyanoacrylate and Tris-Acryl Microspheres for Bronchial Artery Embolization in Patients with Cystic Fibrosis and Hemoptysis: A Retrospective Cohort Study

Purpose: To compare the effectiveness and safety of bronchial artery embolization using n-butyl-2-cyanoacrylate (nBCA) versus tris-acryl microspheres in patients with cystic fibrosis. Materials and Methods: Fifty-eight patients with severe hemoptysis (>100 mL/24 h) who underwent endovascular embolization between June 2019 and July 2024 were retrospectively analyzed. Patients were divided into 2 subgroups based on the embolic agent used: nBCA (n = 38) and tris-acryl microspheres (n = 20). Technical success, primary and secondary clinical success, safety, and recurrence rates were evaluated. Potential predictors of recurrence—including the number of pathological arteries identified on computed tomography (CT) angiography, the number and caliber of treated vessels, laterality, and embolized vascular district (bronchial vs nonbronchial systemic arteries)—were assessed using appropriate univariate tests. Results: Technical success was achieved in all procedures. Primary clinical success was obtained in 57 of 58 patients (98.3%). During follow-up (mean, 42.9 months [SD ± 12.3]), recurrence occurred in 10 of 58 patients (17.2%), with a significantly higher relapse rate in the microsphere group (10 of 20, 50%) and no recurrences in the nBCA group (0 of 38) (P = .0005). Most recurrences (7 of 10) originated from nonbronchial systemic arteries previously embolized with microspheres. No major adverse events were observed. No other variable—including age, number of pathological arteries on CT angiography, vessel caliber, or laterality—showed a significant association with recurrence. Conclusions: nBCA was associated with lower recurrence rates compared with tris-acryl microspheres. More relapses arose from nonbronchial systemic arteries. Further studies with larger cohorts are needed to confirm these findings and to evaluate additional factors influencing outcomes.