First use of Amplatzer device for bronchopleural fistula after lung transplantation

López, Antolina Gómez; Luján, Ricardo García; Gafas, Alicia de Pablo; Hernández, Felipe; Garrido, Victoria Villena; Valipour, Arschang; Pardo, José Carlos Meneses; Poch, Eduardo de Miguel

doi:10.1136/thoraxjnl-2016-209543

Cited by 9 publications

(4 citation statements)

References 9 publications

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“…Alternatively, many reports of successful bronchoscopic techniques and options of BPF closure using different devices have been attempted. These include antibiotics [ 10 ], cellulose [ 11 ], ethanol [ 12 ], cyanoacrylate compounds [ 13 , 14 ], vascular devices and plugs [ [15] , [16] , [17] ], fibrin or tissue glue [ [18] , [19] , [20] ], Watanabe spigots [ 21 ], EBVs [ [22] , [23] , [24] ], and autologous blood patches [ 25 ]. All have reported variable success rates and their own inherent limitations.…”

Section: Discussionmentioning

confidence: 99%

Extracellular matrix fistula plug for repair of bronchopleural fistula

Sakata

Reisenauer

Kern

et al. 2018

Respiratory Medicine Case Reports

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IntroductionBronchopleural fistula (BPF) is a feared complication of pulmonary resection. Fistula plugs (FP) have been described as an adequate treatment in anorectal disease. We describe our early experience placing an FP in the treatment of BPF.Materials and methodsWe retrospectively reviewed 5 patients for whom a FP was placed for BPF at our institution. Demographic data, initial perioperative information, method and technique of FP placement, and success is reported.ResultsFive patients (4 male, 1 female) with a median age of 63 years (range, 57–76 years) underwent 6 FP placements for BPF. Two patients were post-pneumonectomy and 3 patients post-lobectomy. The median time to presentation following surgery was 118 days (range 22–218). Upon bronchoscopic or operative re-evaluation, 3 patients had successful cessation of their air leak at 0, 1 and 4 days. Two of three patients subsequently underwent a thoracic muscle flap placement to augment healing. One patient had a persistent air leak despite 2 separate FP placements. The air leak stopped with endobronchial valves (EBV) which were deployed proximal to the FP, 9 days after placement of the FP. Another patient had a successful muscle flap placed 80 days after FP placement. There were no complications associated with the FP. Three of five patients were deemed successfully treated with FP placement alone.ConclusionIn patients with a postoperative BPF and pleural window, placement of a FP had a modest success rate and can be considered as a treatment modality option for BPF.

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Section: Discussionmentioning

confidence: 99%

Extracellular matrix fistula plug for repair of bronchopleural fistula

Sakata

Reisenauer

Kern

et al. 2018

Respiratory Medicine Case Reports

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“…The use of metallic stents promotes granulation formation and can help seal the fistula site. Devices such as the Amplatzer device can also be used in select cases [53]. When bronchomediastinal fistulas are present, patients will present with signs and symptoms of mediastinal infections.…”

Section: Bronchial Fistulaementioning

confidence: 99%

Airway Complications after Lung Transplantation

Mahmood,

Mahajan

2024

OBM Transplant

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Lung transplantation in patients with end stage lung disease can improve survival and quality of life. Airway complication incidence varies between 2-33%, but the true incidence is difficult to determine due to a lack of validated classification systems. There are many risk factors for post lung transplant airway complications, the most common being anastomotic ischemia, pulmonary infections, surgical technique and allograph dysfunction. Common complications include formation of granulation tissue, anastomotic stenosis, bronchial fistulas, anastomotic dehiscence, transplant related bronchomalacia and anastomotic infections. While the incidence of airway complications post-transplantation is low, they are associated with significant morbidity. Most of the complications can be managed via bronchoscopic interventions, but do require repeated procedures and hospitalizations.

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“…The central waist typically ranges in diameter between 4 and 40 mm, while the distal and proximal disk diameters are 14 and 10 mm larger, respectively, providing an anchoring lip of 5-7 mm circumferentially. Given the variable size of these devices, use in large BPF has been reported with successful closure [51,52]. Here, the Amplatzer device is delivered by extruding a disk distal to the fistula opening and situating the central waist inside the defect, followed by deploying the second disk on the proximal side of the BPF to anchor the device in place.…”

Section: Interventions For Bronchopleural Fistulae Managementnonsurgicalmentioning

confidence: 99%

An update on bronchopleural fistulae following cancer-related surgery

Bashour

Ost

2023

Current Opinion in Pulmonary Medicine

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Purpose of ReviewBronchopleural fistulae (BPF) are rare complications in cancer-related surgery but impart significant morbidity and mortality. BPF may be difficult to identify, with a broad differential diagnosis at presentation, so it is critical to be aware of newer diagnostic and therapeutic approaches for this disease entity.Recent FindingsMultiple novel diagnostic and therapeutic interventions are featured in this review. Reports of newer bronchoscopic techniques to localize BPF, as well as approaches for bronchoscopic management, like stent deployment, endobronchial valve placement, or alternative interventions when indicated are discussed, paying particular attention to factors that influence procedure selection.SummaryManagement of BPF remains highly variable, but several novel approaches have shown improved identification and outcomes. Although a multidisciplinary approach is imperative, an understanding of these newer techniques is important to provide optimal care for patients.

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First use of Amplatzer device for bronchopleural fistula after lung transplantation

Cited by 9 publications

References 9 publications

Extracellular matrix fistula plug for repair of bronchopleural fistula

Extracellular matrix fistula plug for repair of bronchopleural fistula

Airway Complications after Lung Transplantation

An update on bronchopleural fistulae following cancer-related surgery

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