Management of obstructing pulmonary broncholithiasis with three-dimensional imaging and holmium laser lithotripsy.
Major airway obstruction due to broncholithiasis produces significant morbidity, and management is difficult. Many of the patients are elderly and are not good candidates for surgical removal. Bronchoscopic removal may be limited due to anatomic considerations, skill of the bronchoscopist, and exposure of the patient to additional procedural risks. Preprocedural planning with three-dimensional (3D) multidetector CT (MDCT) imaging enhances the bronchoscopist's knowledge of the relationships of the target lesions with critical structures, and improves the efficiency of the application of specific endobronchial therapies. Here we report our experience treating obstructing broncholithiasis in two patients utilizing pretreatment planning with 3D MDCT imaging, followed by bronchoscopically delivered holmium laser fragmentation of the stones.
Ferguson
J Scott
JS
Department of Internal Medicine, Division of Pulmonary, Critical Care, and Occupational Medicine, University of Iowa, Iowa City, IA 52242-1089, USA. john-s-ferguson@uiowa.edu
Rippentrop
Jonathan M
JM
Fallon
Bernard
B
Ross
Alan F
AF
McLennan
Geoffrey
G
D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy; D001982:Bronchial Diseases / Q000628:therapy*; D005260:Female; D006695:Holmium; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D020347:Lithiasis / Q000628:therapy*; D017602:Lithotripsy, Laser / Q000379:methods*; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods
D006695:Holmium