Source: Annual Congress 2004 - New developments in endobronchial treatment
Disease area: Airway diseases, Thoracic oncology

Abstract

Objective: To assess the efficacy of fiberoptic bronchoscopic balloon dilatation (FBD) in the treatment of bronchial stenoses (BS) after lung transplantation (LT).
Methods: Prospective study, from 1995 to 2002, of LT recipients presenting over 75% of airway narrowing, who underwent FBD with high-pressure balloon catheters. Over a guidewire, the balloon was positioned across the stenosis, and inflated for 30 s. Inflation-deflation cycles were repeated to achieve complete airway patency. A new session was carried out in case of symptom recurrence or spirometric impairment.We evaluated the initial technical succes, as well as evolution of the bronchial lumen, spirometry and symptoms due to BS.
Results: A total of 28 procedures were performed (mean: 3,1; r: 1-8) in 9/219 (4%) LT recipients with diagnosis of BS. The sites of the stenoses were bronchus intermedius (n=5), left mainstem bronchus (n=2), right mainstem bronchus (n=1), and bilateral (n=1). Successful dilatation, with improvement of airway diameter, symptoms and spirometric values (FVC, p = 0,021) was achieved in 8 cases. No major complications were observed after the technique. During follow-up (mean: 31,3 mo; r: 6 - 75) treatment was definitive in 3 cases; 4 patients required bronchial stent placement; 2 patients suffered from partial recurrence.
Conclusions: FBD is a safe and efficient method to restore bronchial diameter in BS following LT, and may lead to clinical and spirometric improvement. It could be a definitive treatment in 1/3 of the cases precluding the need for other interventions.

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Citations should be made in the following way:
D. De la Rosa, J. De Gracia, A. Alvarez, E. Catalan, M. Culebras, C. Bravo (Barcelona, Spain). Fiberoptic bronchoscopic balloon dilatation in the management of bronchial stenosis after lung transplantation. Eur Respir J 2004; 24: Suppl. 48, 4296

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