Abstract
BACKGROUND: Bronchial Artery Embolization (BAE) is a well-established, non-surgical treatment for hemoptysis. This systematic review aims to update the current literature on BAE for hemoptysis, focusing on indications, techniques, complications, clinical outcomes, and recurrence rates. METHODS: We conducted a systematic review of studies published between May 2016 and July 2025. Eligible studies included patients who underwent BAE for hemoptysis, with more than 50 participants and detailed reporting on indications, techniques, complications, outcomes, and recurrence rates. RESULTS: Thirty-two studies were included. The leading causes of hemoptysis were bronchiectasis (27%), post-tubercular sequelae (17.7%), tuberculosis (15.6%), and lung malignancies (15%). Technical success rates ranged from 64% to 100%, with a median technical success of 98.1% (IQR 91.2-100%). Immediate clinical success ranged from 77.3% to 100%, with a median of 94.0% (IQR 89.8-97.9%). Recurrence rates ranged from 5.2% to 55%. The pooled median recurrence rates were 10.6% (IQR 6.9-19.1%) at 6 months, 23.0% (IQR 19.7-28.3%) at 1 year, 29.8% (IQR 25.2-36.6%) at 2 years, and 34.6% (IQR 34.0-37.3%) at 4-5 years. Complications were predominantly minor (median 10.6%) while major complications occurred in 0-4.8% of cases. CONCLUSION: BAE remains a highly effective and minimally invasive treatment for hemoptysis, with high success and low complication rates. Recurrence can be reduced through optimized imaging, CTA-guided planning, and tailored embolization techniques. A multidisciplinary, patient-centered strategy incorporating radiologic expertise and emerging AI tools may further enhance outcomes and prevent recurrence.