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Endobronchial closure of bronchopleural fistulas with Amplatzer vascular plug
- Publication Year :
- 2011
- Publisher :
- Oxford University Press, 2011.
-
Abstract
- OBJECTIVE: Bronchopulmonary fistula (BPF) is a severe complication following lobectomy or pneumonectomy and is associated with a high rate of morbidity and mortality. We have developed a novel minimally invasive method of central BPF closure using Amplatzer vascular plug (AVP) device that was originally designed for the transcatheter closure of vascular structures in patients with small BPF. METHODS: Patients with BPFs were treated under conscious sedation by bronchoscopic closure of BPFs using AVP. After locating the fistula using bronchography, the self-expanding nitinol made AVP occluder to be delivered under direct bronchoscopic guidance over a loader wire into the fistula followed by bronchography to assure correct device positioning and sealing of the BPF. RESULTS: Six AVPs were placed in five patients, four males and one female, with a mean age of 62.3 years (range: 51–82 years). The underlying disorders and etiologies for BPF development were lobectomy (two patients), pneumonectomy for lung cancer (one patient), lobectomy due to necrotizing pneumonia (one patient), and post-tracheostomy tracheo-pleural fistula (one patient). In all the patients, the bronchoscopic procedure was successful and symptoms related to BPF disappeared following closure by the AVP. The results were maintained over a median follow-up of 9 months (range: 5–34 months). CONCLUSIONS: Endobronchial closure using the AVP is a safe and effective method for treatment of small postoperative BPF. The ease of their implantation by bronchoscopy under conscious sedation adds this novel technique to the armatorium of minimally invasive modalities for the treatment of small BPF.
- Subjects :
- Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Septal Occluder Device
Fistula
medicine.medical_treatment
Sedation
Thoracic
Pneumonectomy
Bronchoscopy
Medicine
Humans
Minimally Invasive Surgical Procedures
Aged
Aged, 80 and over
Bronchography
medicine.diagnostic_test
business.industry
Respiratory Tract Fistula
General Medicine
Middle Aged
Pleural Diseases
medicine.disease
Bronchial Fistula
Surgery
Treatment Outcome
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....f62db671c4210263d78fbe65d3e6e731