title: Use of endobronchial valves for the treatment of bronchopleural fistulas after thermal ablation of lung neoplasms.
abstract: Persistent air leaks resulting from bronchopleural fistulas (BPFs) are a rare but serious side effect of thermal ablation. Traditionally, BPFs are treated with surgery; however, patients receiving ablation are often poor surgical candidates and require minimally invasive treatment. The present report describes four cases of BPFs following ablation, which were treated with endobronchial valves (EBVs). In three of the four patients, the pneumothoraces resolved after valve placement. One patient required further treatment with pleurodesis. EBVs can selectively block inspiratory airflow while allowing expiratory flow with drainage of air and secretions. In select patients, EBVs are a viable treatment option for BPFs.
authors.affiliation: Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA. erica_alexander@brown.edu
authors.forename: Erica S
authors.initials: ES
authors.lastname: Alexander
authors.forename: Terrance T
authors.initials: TT
authors.lastname: Healey
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Martin
authors.forename: Damian E
authors.initials: DE
authors.lastname: Dupuy
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects*; D000368:Aged; D021721:Balloon Occlusion; D001983:Bronchial Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001999:Bronchoscopy / Q000295:instrumentation*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008872:Microwaves / Q000009:adverse effects; D008875:Middle Aged; D010995:Pleural Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D018700:Pleurodesis; D011030:Pneumothorax / Q000209:etiology / Q000601:surgery; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation*; D012086:Reoperation; D016156:Respiratory Tract Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome