title: Successful exclusion of a large bronchopleural fistula using an Amplatzer II vascular plug and glue embolization.
abstract: We report a case of a 63-year-old man with a complicated postsurgical bronchopleural fistula (BPF), which was treated with a minimally-invasive hybrid procedure using fluoroscopy, bronchoscopy, and thoracoscopy. A previous surgical attempt had failed to seal the pathologic tract. An Amplazter II vascular plug was successfully deployed into the BPF, followed by autologous blood and glue injection. An adjunctive endoscopically-guided glue embolization was deemed necessary. The 14-month clinical and imaging follow-up confirmed the successful exclusion of the BPF. No migration of the device was noted and the patient remained asymptomatic. The combined endoscopic and fluoroscopic guided management of a BPF using the Amplatzer II vascular plug and glue was proven safe and effective after mid-term follow-up.
authors.affiliation: Department of Radiology, Guy's and St Thomas' Hospitals, NHS Foundation Trust, London, UK. stavspiliop@upatras.gr
authors.forename: Stavros
authors.initials: S
authors.lastname: Spiliopoulos
authors.forename: Miltiadis
authors.initials: M
authors.lastname: Krokidis
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Gkoutzios
authors.forename: Andrew
authors.initials: A
authors.lastname: McGrath
authors.forename: Irfan
authors.initials: I
authors.lastname: Ahmed
authors.forename: Narayan
authors.initials: N
authors.lastname: Karunanithy
authors.forename: Tom
authors.initials: T
authors.lastname: Routledge
authors.forename: Tarun
authors.initials: T
authors.lastname: Sabharwal
authors.forename: Andreas
authors.initials: A
authors.lastname: Adam
mesh_terms: D001983:Bronchial Fistula / Q000175:diagnosis / Q000628:therapy*; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000601:surgery; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging; D004621:Embolization, Therapeutic / Q000379:methods*; D005471:Fluoroscopy; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000175:diagnosis / Q000628:therapy*; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy*; D011506:Proteins / Q000627:therapeutic use*; D055989:Septal Occluder Device; D020775:Thoracic Surgery, Video-Assisted; D013906:Thoracoscopy; D014014:Tissue Adhesives / Q000627:therapeutic use*
chemical_list: C472676:Bio-glue; D011506:Proteins; D014014:Tissue Adhesives