ArticleBMC pediatrics2026
Transcatheter embolization of systemic artery-to-pulmonary artery shunts with n-butyl-2-cyanoacrylate for pediatric hemoptysis: a single-center retrospective study.
Article in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSystemic artery-to-pulmonary artery (SA-PA) shunt represents a critical pathological mechanism underlying hemoptysis in pediatric patients, yet focused interventional research targeting this specific condition remains limited. Traditional embolic materials are frequently associated with elevated recurrence rates in SA-PA shunt cases. This study assesses the effectiveness and safety profile of n-butyl-2-cyanoacrylate (NBCA) embolization for hemoptysis secondary to pediatric SA-PA shunts, while examining the clinical significance of individualized NBCA dilution protocols.
methodsThis study retrospectively reviewed pediatric hemoptysis cases treated with NBCA embolization for SA-PA shunts at a single center from May 2021 to March 2025. Baseline characteristics, culprit feeding artery features, and NBCA-Lipiodol mixing ratios were collected. The primary study endpoints were technical success rate, 24-hour clinical success rate, incidence of severe complications, and hemoptysis recurrence rate. The Kaplan-Meier analysis was applied to generate the hemoptysis-free survival curve.
resultsThe study cohort comprised 26 pediatric patients (mean age, 9.12 ± 3.44 years; 12 males and 14 females). Fifty-one abnormal systemic feeding arteries were embolized: 16 (31.4%) orthotopic bronchial arteries, 9 (17.6%) ectopic bronchial arteries, and 26 (51.0%) non-bronchial systemic arteries. The mixing ratio of NBCA-Lipiodol varied between 1:2 and 1:4. The rates of technical success and 24-hour clinical success both reached 100.0%. The early (≤ 1 year) hemoptysis recurrence rate was 7.7%, with no late hemoptysis recurrence over a median 25-month follow-up. Kaplan-Meier analysis showed that median hemoptysis-free survival was not reached.
conclusionsNBCA embolization achieved favorable safety and efficacy profiles in managing SA-PA shunt-related hemoptysis among pediatric patients, demonstrating sustained clinical benefit with limited disease recurrence. It is a valuable interventional treatment option worthy of clinical promotion.
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