Sclerotherapy of malignant pleural effusion through sonographically placed small-bore catheters.
Pleural sclerosis after drainage with a small-bore catheter was performed in 21 patients with malignant pleural effusions. Intrapleural catheters 7- to 24-French in size were placed by using sonographic guidance. Tetracycline (18 patients) and bleomycin (four patients) were used as sclerosing agents (one patient had both). Clinical and radiologic follow-up was available on all patients until they died (range, 2 weeks to 25 months; mean, 3.6 months). Pleural sclerosis was successful in 15 (71%) of 21 patients. Two patients in whom pleurodesis failed had pleural sclerosis repeated, with one success and one failure. All of the failures were in patients in whom the amount of chest-tube drainage was more than 100 ml/day. Pleurodesis with tetracycline was painful in six patients; no pain was associated with use of bleomycin. Small pneumothoraces developed in four patients at the time of chest-tube placement, without consequence. A superimposed infection that developed in a patient having continuous drainage of pleural fluid was successfully treated with antibiotics. Pleural sclerotherapy can be performed through sonographically placed small-bore catheters with results comparable to those seen with large-bore, surgically placed catheters.
Department of Radiology, Massachusetts General Hospital, Boston 02114.
M C
MC
Morrison
P R
PR
Mueller
M J
MJ
Lee
S
S
Saini
J A
JA
Brink
S L
SL
Dawson
E D
ED
Cortell
P F
PF
Hahn
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001761:Bleomycin / Q000008:administration & dosage; D002404:Catheterization / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010994:Pleura; D016066:Pleural Effusion, Malignant / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D015911:Sclerotherapy / Q000295:instrumentation / Q000379:methods*; D013752:Tetracycline / Q000008:administration & dosage; D014465:Ultrasonics
D012597:Sclerosing Solutions; D001761:Bleomycin; D013752:Tetracycline