Journal of bronchology & interventional pulmonology
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J Bronchology Interv Pulmonol · Jan 2013
Safety of ultrasound-guided small-bore chest tube insertion in patients on clopidogrel.
The safety of small-bore chest tubes insertion with ultrasound (US) guidance has been well demonstrated in patients not receiving antiplatelet therapy. Given the current widespread use of these agents, pulmonologists frequently encounter patients on this therapy and requiring drainage of the pleural space. The use of these agents clearly increases the risk of bleeding, but it is not always possible to stop this therapy before the procedure, especially in patients requiring urgent drainage and those with coronary stents. The purpose of this study is to report our experience on the safety of US-guided small-bore chest tube placement in patients receiving clopidogrel. ⋯ OH 44195: The insertion of small-bore chest tube in patients receiving clopidogrel can be safe if performed by experienced operators and by using US guidance along with lateral insertion site, which has the lowest risk of lacerating the intercostal arteries.
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J Bronchology Interv Pulmonol · Jan 2013
Temporary use of silicone stents for severe airway stenosis in untreated malignant lymphoma.
Airway stenting has become a popular method for palliation of airway stenosis; however, little has been reported about their use for patients with malignant lymphoma that occasionally causes a life-threatening condition. The aim of the study was to evaluate the efficacy and safety of airway stenting in chemoradiotherapy naive patients with severe airway stenosis due to malignant lymphoma. ⋯ Airway stenting using silicone stents is safe and effective in palliation of airway stenosis in patients with untreated malignant lymphoma, and permits postprocedural tumor-specific therapy. The response to tumor-specific therapy can be expected, and so removable stents should be selected.
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J Bronchology Interv Pulmonol · Jan 2013
ReviewLinear EBUS in staging non-small cell lung cancer and diagnosing benign diseases.
As an evolving technique, linear endobronchial ultrasound is becoming the first choice and standard of care not only to diagnose the malignant and benign mediastinal lesions but also to stage non-small cell lung cancer. Lung cancer is the leading cause of cancer-related mortality in both men and women. The disease causes more death compared with colorectal, breast, and prostate cancers combined in the United States. ⋯ Determining the cell type and its molecular characteristics allow targeted treatments in adenocarcinoma. The diagnosis of indeterminate mediastinal lymph nodes or masses and staging lung cancer might be challenging. This article will review the principles and clinical utility of endobronchial ultrasound in mediastinal lesions.
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J Bronchology Interv Pulmonol · Jan 2013
Case ReportsTreatment of severe advanced emphysema with volume reduction using lung sealant: a case report of 2 patients.
Emphysema is a progressive and irreversible disease for which there is no cure to date. The patients experience debilitating shortness of breath with repetitive exacerbations and poor quality of daily life. At present, patients with severe emphysema have limited treatment options. Endoscopic lung-volume reduction with valve implantation or using lung sealant is a treatment option for patients with severe emphysema. By our patients, we detected collateral channels, which allow airflow into the target lobe and prevent atelectasis and significant lung-volume reduction. Thus, we decided to treat the advanced emphysema of our patients with endoscopic volume reduction using lung sealant (AeriSeal). Lung-volume reduction surgery reduces hyperinflation and improves lung function by removal of emphysematous lung tissue. However, lung-volume reduction surgery is also associated with significant short-term morbidity and mortality. Results from recently published Endobronchial Valve for Emphysema Palliation Trail (VENT) and Exhale Airway Stents for Emphysema (EASE) trial showed that treatment was substantially less effective and did not consistently reduce hyperinflation or improve lung function mostly likely due to collateral ventilation present in majority of patients. There is a volume reduction therapy in case of detection of collateral flow; use of a lung sealant is a possible alternative. ⋯ Correlation and comparisons between changes in primary and secondary outcome measures in the lung function parameters and 6-minute walking test before and after the application of AeriSealant revealed significant reduction of hyperinflation and improvement both in the flow rates and physical capacity of our patients.
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J Bronchology Interv Pulmonol · Jan 2013
Letter Case ReportsBronchial stenosis after iron pill aspiration.