Treatment of pleural effusions and pneumothorax with catheters placed percutaneously under imaging guidance

Reinhold, Caroline; Illescas, F F; Atri, Mostafa; Bret, Patrice

doi:10.2214/ajr.152.6.1189

Cited by 58 publications

(21 citation statements)

References 11 publications

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“…The incidence of pneumothorax varies 8±60%, with a mean of 20%. Less than 5% of patients have persistent clinical symptoms and require aspiration or drainage [14,18,19,25]. needle passes, diameter and¯exibility of the needle, depth and diameter of the target, dif®culty of localization, cavitary lesion, and mechanical ventilation.…”

Section: Complicationsmentioning

confidence: 99%

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Imaging guided thoracic interventions

Ghaye¹,

Dondelinger²

2001

Eur Respir J

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Interventional Radiology is a technique based medical specialty, using all available imaging modalities (¯uoroscopy, ultrasound, computed tomography, magnetic resonance, angiography) for guidance of interventional techniques for diagnostic or therapeutic purposes.Actual, percutaneous transthoracic needle biopsy includes core needle biopsy besides ®ne needle aspiration. Any pleural, pulmonary or mediastinal¯uid or gas collection is amenable to percutaneous pulmonary catheter drainage.Treatment of haemoptysis of the bronchial artery or pulmonary artery origin, transcatheter embolization of pulmonary arteriovenous malformations and pseudoaneurysms, angioplasty and stenting of the superior vena caval system and percutaneous foreign body retrieval are well established routine procedures, precluding unnecessary surgery. These techniques are safe and effective in experienced hands.Computed tomography is helpful in pre-and postoperative imaging of patients being considered for endobronchial stenting. Many procedures can be performed on an outpatient basis, thus increasing the cost-effectiveness of radiologically guided interventions in the thorax.

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Section: Complicationsmentioning

confidence: 99%

“…5). Success rate of drainage of iatrogenic pneumothorax is 75±97%, the vast majority resolving within 24±72 h [18,19,25,86,107,108]. Catheters can be connected to a one-way Heimlich valve.…”

Section: Pleural Collectionsmentioning

confidence: 99%

Imaging guided thoracic interventions

Ghaye¹,

Dondelinger²

2001

Eur Respir J

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“…Large-bore chest tubes, however, limit patient mobility and can cause significant patient discomfort. More recently, small-bore catheters were placed with radiological guidance with no noticeable difference in response rates [5, 6, 7, 8]; the catheters were well tolerated and accompanied by minimal complications.…”

Section: Introductionmentioning

confidence: 99%

The Value of Small-Bore Catheter Thoracostomy in the Treatment of Malignant Pleural Effusions

Şahin

Ünlü²,

Akkaya³

et al. 2001

Respiration

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Background: Malignant pleural effusions can cause severe debilitating symptoms and impair the quality of life. Treatment is often palliative, usually consisting of sequential thoracenteses or tube thoracostomy with or without sclerotherapy. Large-bore thoracostomy tubes have traditionally been used for drainage and sclerotherapy. More recently, the use of small-bore catheters has been studied. Objectives: To assess the efficacy and safety of small-bore catheter (Pleuracan^®) thoracostomy combined with talc sclerotherapy for palliative treatment of malignant pleural effusions. Methods:Between May 1998 and March 2000, 24 consecutive patients presenting at our inpatient clinic were studied. Follow-up radiography at the end of the 1st month (immediate response) and 3rd month (long-term follow-up) after talc pleurodesis was performed to assess the response rates. Results: Of the 24 patients included, 2 patients did not show lung expansion after pleural drainage. Two patients died within 30 days after talc pleurodesis and 1 did not undergo 30-day postpleurodesis radiography. The remaining 19 patients made up the study group to assess the response rates (8 men, 11 women). Overall response rates of talc pleurodesis via small-bore catheter were found to be 84.2% [complete response (CR): 68.4%, partial response (PR): 15.8%] at 30-day and 78.6% (CR: 57.2%, PR:2 1.4%) at 90-day follow-up, respectively. One patient reported moderate pain during catheter placement. Four patients experienced mild to moderate pleuritic chest pain, shortness of breath, or both within 4 h after instillation. Seven of the 22 patients (31.8%) had a transient fever (≤39.0°C) 6–24 h after talc instillation that lasted less than 24 h and was successfully treated with acetaminophen. One patient had significant subcutaneous emphysema that resolved in 24 h. Four patients died because of tumor progress (2 patients in the 1st month and 2 patients between 30 and 90 days). Conclusion:Pleurodesis can successfully be performed via a small-bore catheter in patients with recurrent malignant pleural effusion. To validate the results of the study, a prospective randomized study, comparing this device (Pleuracan) and a ‘standard’ 16- to 24-french chest drain, should be performed.

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“…Large-bore chest tubes, however, limit patient mobility and are uncomfortable. More recently, small-bore catheters were placed with radiologic guidance with no noticeable difference in response rates (8)(9)(10)(11); the catheters were well tolerated and accompanied by minimal complications. Although a number of sclerosing agents have been tried, talc has been used for years as it is inexpensive, has few side effects, and has proved to be effective when administered via a large thoracostomy chest tube or thoracoscope (12)(13)(14)(15)(16).…”

mentioning

confidence: 99%

Malignant Pleural Effusions: Treatment with Small-Bore-Catheter Thoracostomy and Talc Pleurodesis

Marom¹,

Patz²,

Erasmus³

et al. 1999

Radiology

101

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Thirty-two patients with a known primary malignancy and a symptomatic malignant pleural effusion underwent small-bore-catheter thoracostomy and talc pleurodesis. Twenty-three patients (72%) had a complete response; four (12%), a partial response; and five (16%), no response. Symptoms in all those who responded were clinically improved. Complications included fever in 13 patients (41%) and moderate shortness of breath, chest pain, or both in six (19%). Small-bore-catheter thoracostomy and talc pleurodesis was successful in treating malignant pleural effusions.

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Treatment of pleural effusions and pneumothorax with catheters placed percutaneously under imaging guidance

Cited by 58 publications

References 11 publications

Imaging guided thoracic interventions

Imaging guided thoracic interventions

The Value of Small-Bore Catheter Thoracostomy in the Treatment of Malignant Pleural Effusions

Malignant Pleural Effusions: Treatment with Small-Bore-Catheter Thoracostomy and Talc Pleurodesis

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