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Ann Thorac Surg 2006;82:1924-1926
© 2006 The Society of Thoracic Surgeons


How To Do It

Transthoracic Closure of a Postpneumonectomy Bronchopleural Fistula With Coils and Cyanoacrylate

Lindsey A. Clemson, BSa, Eric Walser, MDb, Amanjit Gill, MDb, James E. Lynch, BS, RRTc, Joseph B. Zwischenberger, MDc,*

a School of Medicine, The University of Texas Medical Branch, Galveston, Texas
b Department of Radiology, The University of Texas Medical Branch, Galveston, Texas
c Department of Surgery, The University of Texas Medical Branch, Galveston, Texas

Accepted for publication January 18, 2006.

* Address correspondence to Dr Zwischenberger, Department of Surgery, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555. (Email: jzwische{at}utmb.edu).

Standard treatment for persistent bronchopleural fistulas involves thoracotomy with primary closure and transposition of a vascularized muscle flap to the bronchial leak site. This major operation may be ineffective or medically contraindicated. We successfully treated 2 patients by insertion of coils and cyanoacrylate glue into and adjacent to the fistula of a postpneumonectomy bronchial stump with computed tomographic-guided transthoracic needle. The coils served as scaffolding for cyanoacrylate glue to control the bronchopleural fistula.




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