title: Efficacy of bronchoscopic closure of a bronchopleural fistula with amplatzer devices: long-term follow-up.
abstract: BACKGROUND
  The development of a bronchopleural fistula (BPF) is associated with high rates of morbidity and mortality. We have developed a minimally invasive method of bronchoscopic BPF closure using Amplatzer devices (AD) and Amplatzer vascular plugs (AVP), with excellent short-term results.
  
  
  OBJECTIVE
  The aim of the present report was to explore the long-term outcome of patients treated by Amplatzer occluders and the durability of this novel modality of BPF treatment.
  
  
  METHODS
  A total of 31 central BPF in 31 patients (mean age 66.8 years, range 19-91) were sealed under moderate sedation bronchoscopically by either AD (n = 19) or AVP (n = 12). The average follow-up period was 17.6 months (range 1-68 months).
  
  
  RESULTS
  The main etiology for BPF was surgery (n = 24), pneumonectomy (n = 14) or lobectomy/segmentectomy (n = 10). The underlying disease was either primary (n = 19) or metastatic (n = 2) lung cancer. The immediate success rate was 96% as symptoms related to BPF disappeared in 30 of the 31 patients. Short-term (<30 days) mortality was 13% (4 patients). At follow-up, 14 patients (45%) are still alive. Out of 12 patients with late mortality, in 5 patients (41%) the death was directly related to cancer relapse, and no patient died due to BPF recurrence.
  
  
  CONCLUSIONS
  Endobronchial closure of BPF using both types of Amplatzer occluders (AD and AVP) is a minimally invasive effective modality of treatment with high safety profile and satisfactory long-term outcome considering the poor prognosis in this particular group of patients.
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Oren
authors.initials: O
authors.lastname: Fruchter
authors.forename: Bayya Abed
authors.initials: BA
authors.lastname: El Raouf
authors.forename: Nader
authors.initials: N
authors.lastname: Abdel-Rahman
authors.forename: Milton
authors.initials: M
authors.lastname: Saute
authors.forename: Elchanan
authors.initials: E
authors.lastname: Bruckheimer
authors.forename: Mordechai R
authors.initials: MR
authors.lastname: Kramer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001983:Bronchial Fistula / Q000601:surgery*; D001999:Bronchoscopy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008169:Lung Abscess / Q000601:surgery; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000601:surgery*; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000601:surgery*; D055989:Septal Occluder Device; D016896:Treatment Outcome; D055815:Young Adult