Closure of a Bronchopleural Fistula Using Bronchoscopic Placement of an Endobronchial Valve Designed for the Treatment of Emphysema

Ferguson, J. Scott; Sprenger, Kimberly J.; Natta, Timothy Van

doi:10.1378/chest.129.2.479

Cited by 77 publications

(34 citation statements)

References 5 publications

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“…Other minimally invasive treatment options include the use of one-way endobronchial valves that are also used for the treatment of emphysema (Spiration and Zephyr) and endobronchial Watanabe spigots [12,13,14]. The degree of success is variable and depends on the underlying disease and the proximity and size of the fistulae, with larger fistulae having poor closure rates [7,8,9,10,11]. A large BPF is apparently particularly challenging.…”

Section: Discussionmentioning

confidence: 99%

“…Endoscopic treatment of BPF is based on the delivery of biological glue, coils, covered stents and sealants to the BPF site [5,6,7,8,9,10,11,12,13,14]. The degree of success with bronchoscopic treatment is variable, and depends on the underlying disease, and the proximity and size of the fistulas, with larger fistulas having poor closure rates [6,7,8,9].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of Bronchoscopic Closure of a Bronchopleural Fistula with Amplatzer Devices: Long-Term Follow-Up

et al. 2014

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Background: The development of a bronchopleural fistula (BPF) is associated with high rates of morbidity and mortality. We have developed a minimally invasive method of bronchoscopic BPF closure using Amplatzer devices (AD) and Amplatzer vascular plugs (AVP), with excellent short-term results. Objectives: The aim of the present report was to explore the long-term outcome of patients treated by Amplatzer occluders and the durability of this novel modality of BPF treatment. Methods: A total of 31 central BPF in 31 patients (mean age 66.8 years, range 19-91) were sealed under moderate sedation bronchoscopically by either AD (n = 19) or AVP (n = 12). The average follow-up period was 17.6 months (range 1-68 months). Results: The main etiology for BPF was surgery (n = 24), pneumonectomy (n = 14) or lobectomy/segmentectomy (n = 10). The underlying disease was either primary (n = 19) or metastatic (n = 2) lung cancer. The immediate success rate was 96% as symptoms related to BPF disappeared in 30 of the 31 patients. Short-term (<30 days) mortality was 13% (4 patients). At follow-up, 14 patients (45%) are still alive. Out of 12 patients with late mortality, in 5 patients (41%) the death was directly related to cancer relapse, and no patient died due to BPF recurrence. Conclusion: Endobronchial closure of BPF using both types of Amplatzer occluders (AD and AVP) is a minimally invasive effective modality of treatment with high safety profile and satisfactory long-term outcome considering the poor prognosis in this particular group of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of Bronchoscopic Closure of a Bronchopleural Fistula with Amplatzer Devices: Long-Term Follow-Up

et al. 2014

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“…Several investigators [15][16][17][18][19] have reported the use of this valve in the management of persistent air leaks following many pulmonary diseases; they describe complex clinical cases in which nonsurgical intervention was most appropriate. In our report we focused our attention on the treatment of only postoperative critical cases.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of persistent postoperative air leaks following the placement of an endobronchial one-way valve

Conforti

Torre

Fieschi

et al. 2016

Monaldi Arch Chest Dis

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resection in pathological conditions of the lung involve a very large spectrum of available methods, from chest drainage and placement of Heimlich valves to surgical repair or pleural decortication. However, in some of these patients surgery may be contraindicated. This report describes an endobronchial approach to the control of marked and prolonged air leaks in four patients using a newly designed one-way airway valve (Pulmonx Corporation; Redwood City, Ca.USA) placed into the segmental bronchus that is the source of air leakage. As the device is a one-way inspiratory airway blocker, it can be used to control persistent air leaks while maintaining the drainage of mucus. This approach potentially provides an effective nonsurgical and minimally invasive alternative addition to the armamentarium of treatments for patients who suffer with persistent post-operative air leaks where other methods have failed or in frail patients who are categorised as a high surgical risk.

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“…It may be considered to be associated with natural complications of cancer, immunosuppression status, consequences of pneumonia and necrotic tissue following chemoradiotherapy or invasive procedures (5). The empyema was treated with thoracic drainage, infection control and optimized nutrition (6). However, the management of lung cancer complicated with a thoracic empyema in an older patient remains a challenge.…”

Section: Discussionmentioning

confidence: 99%

Metastatic Lung Cancer Presenting as Thoracic Empyema in an Old Patient

et al. 2014

West Indian Med J

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Closure of a Bronchopleural Fistula Using Bronchoscopic Placement of an Endobronchial Valve Designed for the Treatment of Emphysema

Cited by 77 publications

References 5 publications

Efficacy of Bronchoscopic Closure of a Bronchopleural Fistula with Amplatzer Devices: Long-Term Follow-Up

Efficacy of Bronchoscopic Closure of a Bronchopleural Fistula with Amplatzer Devices: Long-Term Follow-Up

Successful treatment of persistent postoperative air leaks following the placement of an endobronchial one-way valve

Metastatic Lung Cancer Presenting as Thoracic Empyema in an Old Patient

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