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Gogia PG, Garg S, Bhatnagar T, Chopra K, Singuri R, Gildea M, Bhargavi K. Management of bronchopleural fistula using Amplatzer duct occluder device. Lung India 2023; 40:86-88. [PMID: 36695266 PMCID: PMC9894275 DOI: 10.4103/lungindia.lungindia_244_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 01/01/2023] Open
Affiliation(s)
- Pratibha G. Gogia
- Department of Respiratory Medicine, Venkateshwar Hospital, New Delhi, India E-mail:
| | - Salil Garg
- Department of Cardiology, Venkateshwar Hospital, New Delhi, India
| | - Taurn Bhatnagar
- Department of Respiratory Medicine, Venkateshwar Hospital, New Delhi, India E-mail:
| | - Karan Chopra
- Department of Cardiology, Venkateshwar Hospital, New Delhi, India
| | - Ritesh Singuri
- Department of Cardiology, Venkateshwar Hospital, New Delhi, India
| | - M. Gildea
- Department of Respiratory Medicine, Venkateshwar Hospital, New Delhi, India E-mail:
| | - K Bhargavi
- Department of Respiratory Medicine, Venkateshwar Hospital, New Delhi, India E-mail:
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Han YM, Lee HB, Jin GY, Kim KY. Bronchopleural Fistula after Surgery: Therapeutic Efficacy of Bronchial Occluders. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2021; 82:371-381. [PMID: 36238740 PMCID: PMC9431948 DOI: 10.3348/jksr.2020.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/19/2020] [Accepted: 06/16/2020] [Indexed: 11/15/2022]
Abstract
목적 수술 후 발생하는 기관지늑막루에 대한 bronchial occluder device (이하 BOD)의 유용성 및 효과성을 평가하고자 한다. 대상과 방법 2009년도부터 2019년까지 폐암 및 폐결핵으로 수술 후 발생한 7명의 기관지늑막루 환자들 중에 BOD 치료를 실시한 6명의 환자를 대상으로 하였다. 폐암 환자가 5명, 폐결핵 환자는 1명이었다. 남자가 5명, 여자가 1명이었으며 59세에서 74세(평균: 69세)이었다. 진단은 전산화단층기관지 촬영과 기관지내시경으로 실시하였다. 시술은 진단 후 1주에서 2주 사이에 실시하였다. 치료에 사용된 BOD의 기술적 성공 및 임상적 성공을 평가하였다. 시술 후 임상적 치료 효과와 생존 기간 및 부가적인 치료에 대하여 알아보았다. 결과 총 6명 환자 모두에서 시술을 성공적으로 실시하였다. 임상성공 5명에서 있었고, 1명에서는 임상부분성공이 있었다. 임상실패한 경우는 없었다. 기구의 이동이나 천공의 합병증은 없었다. 2명은 전산화단층기관지 촬영으로, 4명은 기관지내시경으로 기관지늑막루를 진단하였다. 수술은 폐엽절제술(lobectomy) 2명, 폐이엽절제술(bilobectomy) 2명, 그리고 전폐절제술(pneumonectomy) 2명이었다. 수술 후 진단까지 걸린 시간은 1개월에서 34개월(평균: 10개월)이었다. 4명(59~103일: 평균 80.5일)은 사망하였고 2명(313일, 3331일)은 생존하였다. 사망 원인이 2명은 기저질환의 악화, 1명은 폐부종 및 흉수, 1명은 폐렴이었다. 한 명에서 부가적인 카테타 배액술, 2명에서 흉관 삽입을 유지하였다. 결론 폐절제 수술 후 발생할 수 있는 기관지늑막루 치료에 있어서 BOD는 유용하고 효과적인 치료 방법이다.
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Affiliation(s)
- Young Min Han
- Department of Radiology, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
- Research Institute of Clinical Medicine, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
- Biomedical Research Institute, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
| | - Heung Bum Lee
- Research Institute of Clinical Medicine, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
- Biomedical Research Institute, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
- Department of Respiratory Allergy Internal Medicine, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
| | - Gong Yong Jin
- Department of Radiology, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
- Research Institute of Clinical Medicine, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
- Biomedical Research Institute, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
| | - Kun Yung Kim
- Department of Radiology, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
- Research Institute of Clinical Medicine, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
- Biomedical Research Institute, Jeonbuk National University Medical School, Jeonbuk National University Hospital, Jeonju, Korea
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Lee S, Lee JH, Kim HB, Lee IJ. Percutaneous Bronchial Embolization to Treat Intractable Bronchobiliary Fistula. Cardiovasc Intervent Radiol 2019; 42:784-786. [PMID: 30684010 DOI: 10.1007/s00270-019-02166-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 01/12/2019] [Indexed: 11/29/2022]
Abstract
Sixty-four-year-old female who underwent hemi-hepatectomy for intrahepatic cholangiocarcinoma a year ago presented with biliary sputum, cough and fever. Cross-sectional imaging showed a recurred tumor involving right diaphragmatic area and an abscess formation in liver dome with adjacent right lower lobe of lung. Percutaneous transhepatic biliary drainage and percutaneous drainage of lung abscess were performed. Tubogram showed connections between the lung abscess cavity and multiple distal bronchi, suggesting bronchobiliary fistulas. Two weeks of drainage treatment did not relieve symptoms. We successfully treated intractable bronchobiliary fistula via image-guided percutaneous access to closest distal bronchi near abscess with subsequent tandem placement of vascular plugs.
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Affiliation(s)
- Seowoo Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jae Hwan Lee
- Department of Radiology, Center for Liver Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea.
| | - Hyun Beom Kim
- Department of Radiology, Center for Liver Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
| | - In Joon Lee
- Department of Radiology, Center for Liver Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
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Customized airway stenting for bronchopleural fistula after pulmonary resection by interventional technique: single-center study of 148 consecutive patients. Surg Endosc 2018; 32:4116-4124. [DOI: 10.1007/s00464-018-6152-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 03/21/2018] [Indexed: 10/17/2022]
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Lignieres M, Roux N, Giorgi R, Gaubert JY, Chaumoitre K, Bartoli JM, Vidal V, Izaaryene J. Persistent pathways after lung radiofrequency ablation as a risk factor of drain placement. Int J Hyperthermia 2017; 33:659-663. [PMID: 28540780 DOI: 10.1080/02656736.2017.1288931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
PURPOSE The risk factors of pneumothorax after lung radiofrequency (RF) ablation are long known. The objective was to demonstrate that the visualisation of an aeric RF path after the needle withdrawal was predictive of pneumothorax occurrence and chest tube placement. MATERIALS AND METHODS A total of 70 patients were retrospectively included in this study. For each patient, we determined the pneumothorax risk factors (age, gender, previous surgery, emphysema, lesion size, distance between pleura and lesion), visualisation of a RF track, length and thickness, presence of pneumothorax, volume, chest tube placement, duration of drainage and hospital stay. RESULTS Among 70 patients included retrospectively, 26 needed a chest tube placement (37%). Considering the group with path visualisation (37 patients, group A) and the patients without path visualisation (group B), the 2 groups were comparable for pneumothorax risk factors. Considering the patients who needed a chest drain, the visualisation of the path was significatively more important (23 cases, 88.4%) (p< 10-3) than in the group without (8 patients, 31.8%). Multivariate analyses were significant in the three analyses after adjustments on the risk factors for the occurrence of pneumothorax. Incidence of drains was significantly more (p < 10-3) important in group A (23 drainages 62%) than in group B (4 drainages or 12%). The length and thickness of the tracks were not predictable of drain placement. CONCLUSIONS Besides the well-known risk factors of severe pneumothorax after lung RFA, the simple visualisation of an aeric path just after the RF needle withdrawal is significantly associated with chest tube placement and can be considered as a risk factor as itself.
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Affiliation(s)
| | | | | | | | - Kathia Chaumoitre
- b Imaging Department , Aix Marseille Université , Marseille , France
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Billè A, Giovannetti R, Calarco G, Pastorino U. Tailored Stent for Bronchial Stump Fistula Closure and Omentoplasty for Infection Control: A Combined Approach with Low Morbidity. TUMORI JOURNAL 2014. [DOI: 10.1177/1636.17938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Andrea Billè
- Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Riccardo Giovannetti
- Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Giuseppe Calarco
- Unit of Endoscopy, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Ugo Pastorino
- Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Vascular occlusion device closure of bronchial stump fistulae: a straightforward approach to manage bronchial stump breakdown. Gen Thorac Cardiovasc Surg 2012; 60:847-50. [DOI: 10.1007/s11748-012-0083-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2011] [Accepted: 02/08/2012] [Indexed: 10/28/2022]
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Spiliopoulos S, Krokidis M, Gkoutzios P, McGrath A, Ahmed I, Karunanithy N, Routledge T, Sabharwal T, Adam A. Successful exclusion of a large bronchopleural fistula using an Amplatzer II vascular plug and glue embolization. Acta Radiol 2012; 53:406-9. [PMID: 22553226 DOI: 10.1258/ar.2012.110688] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We report a case of a 63-year-old man with a complicated postsurgical bronchopleural fistula (BPF), which was treated with a minimally-invasive hybrid procedure using fluoroscopy, bronchoscopy, and thoracoscopy. A previous surgical attempt had failed to seal the pathologic tract. An Amplazter II vascular plug was successfully deployed into the BPF, followed by autologous blood and glue injection. An adjunctive endoscopically-guided glue embolization was deemed necessary. The 14-month clinical and imaging follow-up confirmed the successful exclusion of the BPF. No migration of the device was noted and the patient remained asymptomatic. The combined endoscopic and fluoroscopic guided management of a BPF using the Amplatzer II vascular plug and glue was proven safe and effective after mid-term follow-up.
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Affiliation(s)
- Stavros Spiliopoulos
- Department of Radiology, Guy's and St Thomas' Hospitals, NHS Foundation Trust, London, UK.
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Cho YK, Shin JH, Oh YM, Kim TH, Kim EY, Shin DH, Song HY. Experimental lung collapse following deployment of a self-expandable bronchial occluder in a rabbit model. Br J Radiol 2011; 85:e146-52. [PMID: 21385911 DOI: 10.1259/bjr/40247893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Closure of a bronchopleural fistula is required to prevent fatal empyema or aspiration pneumonia. The purpose of this study was to determine the feasibility and efficacy of bronchial occlusion with a self-expandable occluder to induce experimental lung collapse in a rabbit model. METHODS 10 bronchial occluders (wine glass appearance; 8 mm in diameter and 15 mm in length) were implanted in the native left main bronchi of 10 rabbits via an endotracheal route. We analysed the following: (1) diameters and morphological changes of the bronchial occluders during follow-up; (2) percentage volume of the collapsed lung during follow-up; and (3) complications and gross pathology. 1-day and 2-week follow-up CT scans were routinely obtained. Rabbits were sacrificed 4 weeks after the experiment. RESULTS In all 10 rabbits, the bronchial occluders were successfully implanted and were completely expanded within 2 weeks. Complete collapse of the left lung occurred in three rabbits on day 1 and in an additional two rabbits 2 weeks following implantation. Two other rabbits maintained the percentage volume of the collapsed lung between 51% and 99% during follow-up; the other three rabbits had <50% during follow-up. Pneumothoraces occurred in nine rabbits, but completely resolved at the 2-week follow-up. Right lung herniation across the midline progressed 2 weeks after occluder implantation. CONCLUSION Placement of self-expandable occluders in a rabbit bronchus model was feasible and showed a potential to induce artificial lung collapse. While pneumothoraces were common, they resolved during follow-up.
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Affiliation(s)
- Y-K Cho
- Department of Radiology, Eulji Medical Center, University of Eulji College of Medicine, Seoul, Republic of Korea
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Chae EY, Shin JH, Song HY, Kim JH, Shim TS, Kim DK. Bronchopleural fistula treated with a silicone-covered bronchial occlusion stent. Ann Thorac Surg 2010; 89:293-6. [PMID: 20103263 DOI: 10.1016/j.athoracsur.2009.05.068] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2009] [Revised: 04/24/2009] [Accepted: 05/19/2009] [Indexed: 11/26/2022]
Abstract
Bronchopleural fistula (BPF), one of the potentially fatal complications after pulmonary resection, remains a therapeutic challenge. We present a case of postpneumonectomy BPF successfully managed with a silicone-covered bronchial occlusion stent. The BPF was successfully occluded without complications, and there was no stent migration or any other problem seen at the 1-year follow-up. This novel technique can be an effective option for the treatment of postoperative BPF.
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Affiliation(s)
- Eun Young Chae
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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