Endobronchial Argon Plasma Coagulation for Treatment of Dieulafoy Disease

Dalar, Levent; Sökücü, Sinem Nedime; Özdemir, Cengiz; Büyükkale, Songül; Altın, Sedat

doi:10.4187/respcare.03307

Cited by 21 publications

(20 citation statements)

References 7 publications

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“…Most of the cases were reported from Asia (38 patients) [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24], followed by Europe (23 patients) [3,4,[25][26][27][28][29][30][31][32][33][34][35][36][37], North America (seven patients) [38][39][40][41][42][43][44], Oceania (two patients) [5,45], and the country of origin was not reported for three patients (Fig. 2) [46].…”

Section: Continent and Country Of Originmentioning

confidence: 99%

Bronchial Dieulafoy’s disease: a retrospective analysis of 73 cases

Qian

Wei

et al. 2019

BMC Pulm Med

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Background Bronchial Dieulafoy’s disease (BDD) is a rare disease that is known to be a cause of hemorrhage. The characteristics of this disease are still unknown. The present study describes the disorder based on a review of the world’s literature, emphasizing the diagnostic and therapeutic views. Methods A comprehensive research of BDD of the PubMed, Google Scholar, and Web of Science databases was performed. The following data were collected: patient characteristics; chest imaging, bronchoscopy, vascular angiography, and histopathologic examination findings; and treatment rendered. Results 73 cases of BDD have been reported from 1995 to 2019. Most of the cases occurred in Asia (52.1%), followed by Europe (31.5%). Chest imaging findings were non-specific. The main bronchoscopy finding was a nodular or protruding lesion (60.9%). 19 patients underwent bronchoscopic biopsies, 17 had bleeding, and 6 died. Four patients were successfully shown to have vascular malformations under mucosal protrusion by endobronchial ultrasound scan (EBUS). Vascular angiography mainly showed tortuous, dilated bronchial arteries. Vascular angiography mainly showed tortuous, dilated bronchial arteries. The arterial supply was mainly provided by bronchial arteries (48 cases) and the pulmonary circulation (4 cases). The lesions were mainly located in the right bronchus (53 cases). Selective bronchial artery embolization (BAE) was attempted in 38 patients and 20 patients underwent lobectomies. Emergency resection was performed in 15 patients, all of whom survived and had no recurrent hemoptysis. Conclusions Massive hemoptysis was the common manifestation of BDD. Vascular angiography and EBUS is a very useful examination before biopsy. BAE may be used in stable patients, or patients who cannot tolerate surgery, while surgical resection should be considered in patients who are unstable, patients with uncontrolled hemoptysis, or following BAE failure. Electronic supplementary material The online version of this article (10.1186/s12890-019-0863-1) contains supplementary material, which is available to authorized users.

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Section: Continent and Country Of Originmentioning

confidence: 99%

Bronchial Dieulafoy’s disease: a retrospective analysis of 73 cases

Qian

Wei

et al. 2019

BMC Pulm Med

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“…The noncontact feature of APC allows extent and rapid coagulation, but the depth of penetration is more superficial (2-3 mm) and limited by increased tissue resistance after coagulation and desiccation (33,34). The major applications of APC are hemostasis and tissue destruction and particular effective in vascular lesion (35). Besides, APC is an effective therapy for airway obstruction secondary to endobronchial lesion (36).…”

Section: Argon Plasma Coagulation (Apc)mentioning

confidence: 99%

Central airway tumors: interventional bronchoscopy in diagnosis and management

Lin

Chung

2016

J. Thorac. Dis.

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The diagnosis of central airway tumors is usually challenging because of the vague presentations.Advances in visualization technology in bronchoscopy aid early detection of bronchial lesion. Cryotechnology has great impact on endobronchial lesion sampling and provides better diagnostic yield. Airway tumor involvements result in significant alteration in life quality and lead to poor life expectancy. Timely and efficiently use ablation techniques by heat or cold energy provide symptoms relief for central airway obstruction. Prostheses implantation is effective in maintaining airway patency after ablative procedure or external compression. Combined interventional bronchoscopy modalities and other adjunctive therapies have improvement in quality of life and further benefit in survival. This review aims to provide a diagnostic approach to central airway tumors and an overview of currently available techniques of interventional bronchoscopy in managing symptomatic central airway obstruction. Here, we provide a clinical review of interventional bronchoscopy in diagnoses and management of central airway tumors. Keywords Diagnostic modalities Computed tomographyOnly less than 30% patients with tracheal tumors have been diagnosed via chest radiography (14). Traditional CT scan is more sensitive and can provide information on the extent of airway lesions. Newly developed multidetector CT (MDCT) can accurately detect airway tumor locations, natures, quantities (1). The extra luminal anatomy is also clearly depicted. Thus, MDCT is a rapid and non-invasive method to provide comprehensive information about the extent of disease process before surgery or interventional bronchoscopy (1). Visualization of bronchoscopyBronchoscopy is the mainstay to approaching endobronchial lesion under direct vision. In addition to conventionally white light bronchoscopy, autofluorescence (AFB) and narrow band imaging (NBI) are new visualization techniques of bronchoscopy which can aid detection of bronchial mucosa lesions (15). Although the specificity of AFB is low and similar to white light bronchoscopy, there is no doubt in usefulness of detecting early bronchial mucosal lesion and evaluate the margin of mucosal involvement (16,17). NBI is designed to detect angiogenesis and neovascular lesion. The diagnostic accuracy is increased under NBI bronchoscopy (15). Both of them have superior sensitivity comparing with white light bronchoscopy [3][4][5]. Endobronchial ultrasonography (EBUS) is also helpful in evaluating the extent of airway lesion involvement (14,18). Tissue sampling: forceps versus cryotechnologyForceps biopsy under direct bronchoscopic vision is the most common method to obtain tissue sample from endobronchial lesion. However, the size of tissue sample is limited by the forceps size. Small samples with crush artifacts are probably insufficient for accurate diagnosis. The diagnostic yield is only 85% of conventional forceps biopsy and patients usually have to repeat bronchoscopy (2,3).Cryotechnology has been used as a t...

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“…However, the procedure was performed under rigid bronchoscopy in contrast to the flexible bronchoscopic application as we herein describe. [6] APC is an electrosurgical noncontact thermal ablation technique which assists in endobronchial tumor debulking, achieving hemostasis from bleeding endobronchial lesions, removing granulation tissue and as a definitive modality of treating other benign airway disorders. It has been used successfully with both flexible and rigid bronchoscope.…”

Section: Discussionmentioning

confidence: 99%

“…[45] On searching the literature, only one previous report described therapeutic bronchoscopic management for this condition. [6]…”

Section: Introductionmentioning

confidence: 99%

Flexible bronchoscopic argon plasma coagulation for management of massive hemoptysis in bronchial Dieulafoy's disease

et al. 2017

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Dieulafoy's disease is an uncommon condition, the usual site of occurrence being the gastrointestinal tract. The condition refers to the presence of a dysplastic submucosal artery with mucosal vascular branches that has propensity to cause recurrent bleeding. Dieulafoy's disease of the bronchus is rare. Herein, we describe the case of a 26-year-old male who presented with recurrent bouts of hemoptysis and bronchial Dieulafoy's disease was diagnosed. Flexible bronchoscopy was performed, and argon plasma coagulation (APC) of the bleeding lesion was done. The procedure was successful and was followed by complete eradication of the vascular malformation and cessation of hemoptysis. APC is a useful tool in the armamentarium of an interventional pulmonologist that can allow rapid and safe control of bleeding from superficially located and bleeding endobronchial lesions, and can be easily and effectively applied using a flexible bronchoscope.

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Endobronchial Argon Plasma Coagulation for Treatment of Dieulafoy Disease

Cited by 21 publications

References 7 publications

Bronchial Dieulafoy’s disease: a retrospective analysis of 73 cases

Bronchial Dieulafoy’s disease: a retrospective analysis of 73 cases

Central airway tumors: interventional bronchoscopy in diagnosis and management

Flexible bronchoscopic argon plasma coagulation for management of massive hemoptysis in bronchial Dieulafoy's disease

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