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Pulmonary Procedures |

Comparing of Three Different Implantation Strategies on Bronchial Occluder Displacement

Jianlin Hu, MD; Liang Gong, MD; Chen Hu; Chunlan Tang, MD
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Southwest Hospital, Chongqing, China


Chest. 2015;148(4_MeetingAbstracts):817A. doi:10.1378/chest.2280296
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Abstract

SESSION TITLE: Interventional Pulmonology Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Complete bronchial occlusions with occlude divices are useful for the treatment of bronchial fistulas, air leakage, and may be potential strategy for internal lobectomy or segmentectomy. However, displacements of occlude devices leading to bronchial occlusion failure are common. It is quite important to find occlude device implanting strategies preventing occlude devices from displacing.

METHODS: The occlude devices were made with nickel-titanium alloy and silicon membrane and polytetrafluoroethylene membrane (double membranes) by ourselves. Three different occlude device implanting strategies were designed. The first was simple implantation (SI). The second was device implantation plus autoblood injection (IAI): 20ml autoblood were injected into bronchi and alveolae distal to the occlude device. The third was device implantation plus bone cement injection (ICI): 10ml bone cement were injected into bronchi and alveolae distal to the occlude device. Each strategy was performed in 6 adult crossbred dogs under bronchoscopy. All the occlude devices were implanted into right lower segment bronchi. All dogs were observed for two months, and then chest CT was performed for each dog and the lungs of all dogs were dissected. The displacement rates were compared among three strategies.

RESULTS: Displacements were occurred in 5 of 6 dogs with simple implantation (SI group) , 1 of 6 dogs with implantation plus autoblood injection ( IAI group), 1 of 6 dogs with implantation plus bone cement injection ( ICI group ). Compared to SI group, both IAI and ICI group had significantly less displacement rate of occlude devices. ( p <0.01 ). The purulent secretions were observed mostly in IAI group, less in SI group and ICI group. Aculeate rigid solidifications were seen in all dogs of ICI group. The solidification pricked pleurae in two dogs.

CONCLUSIONS: Injection of autoblood into bronchi and alveolae distal to the occlude devices can decrease displacement of occlude devices significantly. It is worthwhile to study further. But infection control should be considered. Although bone cement can also decrease displacement of occlude devices significantly, but solidified bone cement may harmful to adjacent tissues, it is not recommended for further study.

CLINICAL IMPLICATIONS: Although improvement should be made, especially infection control, the strategy of occlude device implantation plus injection of autoblood into bronchi and alveolae distal to the occlude device may be useful for complete bronchial occlusion

DISCLOSURE: The following authors have nothing to disclose: Jianlin Hu, Liang Gong, Chen Hu, Chunlan Tang

No Product/Research Disclosure Information


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