SESSION TITLE: Bronchoscopy & Interventional Procedures
SESSION TYPE: Slide Presentations
PRESENTED ON: Monday, March 24, 2014 at 09:00 AM - 10:30 AM
PURPOSE: The development of Broncho-pleural fistula (BPF) is associated with high rate of morbidity and mortality. We have developed a minimally invasive method of bronchoscopic closure of BPF using Amplazer devices (AD) and Amplazer vascular plugs (AVP), with excellent short-term results. The aim of the present report was to explore the long term outcome of patients and the durability of this novel modality of BPF treatment.
METHODS: A total of 31 central BPF in 31 patients (mean age 66.8 years, range 19-91) were sealed under moderate sedation bronchoscopically by either AD (N = 19) or AVP (N = 12). The average follow-up period was 17.6 months (range 1-68 months)
RESULTS: The main etiology for BPF was surgery (N = 24), pneumonectomy (N =14) or lobectomy/segmentectomy (N = 10). The underlying disease was lung cancer either primary (N = 20) or metastatic (n = 2). The immediate success rate was 96% as symptoms related to BPF disappeared in 30/31 of the patients. Short-term (less than 30 days) mortality was 4/31 (13%). At follow-up, 14 patients (45%) are still alive. Out of 12 patients with late mortality, in 5 patients (41 %) the death was directly related to cancer relapse, and no patient died due to BPF recurrence.
CONCLUSIONS: Conclusion: Endobronchial closure of BPF using both types of Amplatzer occluders (AD, AVP) is a minimally invasive effective modality of treatment with high safety profile and satisfactory long term outcome considering the poor prognosis in this particular group of patients
CLINICAL IMPLICATIONS: Our work can help other physicians to consider Amplatzer occluders as a safe and effective modality of treatment in a poor prognosis group of patients and bring to crucial therapeutic decisions.
DISCLOSURE: The following authors have nothing to disclose: Oren Fruchter, Bayya Abed El Raouf, Milton Saute, Elchanan Bruckheimer, Nader Abdel Rachman, Leonardo Fuks, Mordechai Kramer
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