Emerging technologies for the thorax: Indications, management and complications

Abstract

The field of interventional pulmonology has rapidly expanded to include the management and treatment of complex diseases of the chest. The management of central airway obstruction, pleural disease diagnosis, treatment and palliation, advanced bronchoscopic techniques to aid in the diagnosis of lung cancer and innovative therapies to treat asthma and COPD have all emerged over the past decade. As astute clinicians, we are all aware of the risks and benefits of using these therapies to treat our patients. In order to appropriately treat and manage these often complex medical situations, the physician should have an expert knowledge of all available modalities, the expertise to safely perform the procedure and the ability to minimize the risk of and manage the associated complications that may arise. In this chapter we review and update some of the bronchoscopic and pleural interventions offered by interventional pulmonologists as well as the associated complications and management.

Temoporfin (Foscan®, 5,10,15,20‐Tetra(m‐hydroxyphenyl)chlorin)—A Second‐generation Photosensitizer†,‡

“…The main drawback to both surgical procedures is that mesothelioma has the tendency for frequent local recurrence within a short time with associated high lethality. A recent review on the use of PDT in this area was given by Lindenmann et al (393) while a comparison of the state-of-the-art techniques was published by Yarmus et al (394).…”

Year in review 2010: Tuberculosis, pleural diseases, respiratory infections

“…They also review complications such as postoperative air leaks and chronic pain. Likewise, Yarmus and colleagues discuss the bronchoscopic management of central airway obstruction and the complications associated with these procedures 28 . Newer therapeutic techniques, such as bronchoscopic lung volume reduction, placement of bronchoscopic valves to control prolonged air leaks and bronchial thermoplasty are also discussed, as are advanced diagnostic modalities, such as optical coherence tomography and confocal microendoscopy.…”

Year in review 2010: Interstitial lung diseases, acute lung injury, sleep, physiology, imaging, bronchoscopic intervention and lung cancer

“…A number of excellent reviews on thoracic imaging, PET for lung cancer, indications, contraindications and complications of various interventional procedures pertinent to the thorax such as percutaneous biopsy, radio frequency ablation and transcatheter bronchial artery embolization for massive haemoptysis were published in Respirology 2010, as well as a lively debate on the role of chest X‐ray in an era of rapidly advancing technology 72–75 . Yarmus and Feller‐Kopman 76 comprehensively reviewed indications for emerging technologies including percutaneous cryotherapy for lung cancer treatment, microdebrider for central airway obstruction, photodynamic therapy for malignant mesothelioma, bronchial thermoplasty for asthma, and new diagnostic imaging technologies such as vibration resonance imaging, confocal endoscopy and optical coherence tomography. Colt 77 also provided valuable insights and recommendations on the development and organization of an interventional pulmonology department.…”