Therapeutic effects of 5‐fluorouracil sustained‐release particles in 81 malignant pericardial effusion patients

Ji, Yongli; Li, Rui-Zhi; Xue, Lifang; Li, Ping; Liang, Xiaohong; Dong, Lei; Gao, Yang; Cui, Wen-Chao; Pang, Minxia

doi:10.1016/j.kjms.2014.11.009

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…It is well known that intrapericardial application of chemotherapy is beneficial for the prognosis and quality of life of patients with malignant PE. [76][77][78][79][80] As the EBUS-TBNA needle has an inner stylet the needle can be used to administer chemotherapy which has already been done in malignant enlarged lymph nodes as mentioned above. 15,16,81 It is logical to assume that we could apply with TPEA in the same mode for malignant PEs with good results.…”

Section: Ii) Therapeutic Considerationsmentioning

confidence: 99%

A New Endobronchial Ultrasound (EBUS) Application for Benign and Malignant Pericardial Effusion (PE) Aspiration: Transbronchial Pericardial Effusion Aspiration (TPEA) with a Regular EBUS Transbronchial (TBNA) Needle under Apneic Nasal Jet-Catheter Ventilation

Hohenforst-Schmidt¹,

Steinheimer²,

Rupprecht³

et al. 2016

J. Biomed

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Background: Endobronchial Ultrasound (EBUS) is a state of the art diagnostic tool for the pulmonary physicians, especially for the diagnosis and staging of lung cancer. Pericardial effusion (PE) is examined regularly when either hemodynamic impairment occurs or the ventral PE seems to be at least of 2cm distance on echocardiography. Standard approach is the anterior pericardiocentesis. PE of less than 2cm is not approached in general. Objective: We sought to examine minimal invasively PE in an earlier stage with an aspiration through a regular EBUS-TBNA needle. Due to gravitation posterior PEs are earlier detectable than anterior PEs in a patient supine. Method: Although posterior PE is a contradiction for the standard approach used by cardiologists we punctured the PE from the distal left main or proximal lower lobe bronchus. For the first time we describe our algorithm of Transbronchial PE Aspiration (TPEA) by the usage of a regular EBUS-TBNA needle aspiration controlled by C-arm and regular transthoracic ultrasound. Results: We performed TPEA in deep sedation under nasal jet-ventilation in 10 patients without any severe complications even in anterior PE smaller than 20mm for early diagnosis and in some cases even for treatment in regards to hemodynamics. For the post-puncture period of follow-up over 60 days none of these patients had to be punctured again. Conclusion: Although TPEA is an uncommon and possibly more risky approach than the regular anterior pericardiocentesis it may give a chance to interventional pulmonologists to diagnose PE earlier than achieved by anterior transthoracic ultrasound. At the same time TPEA could offer a new window to the heart for several treatment options beside an effusion retrieval. We additionally build the bridge to possible other applications in different areas in future.

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