Amplatzer Occluders for Effective Nonsurgical Management of Bronchopleural Fistulae.

Abstract

To assess the safety and efficacy of bronchopleural fistulae closure with Amplatzer occluder devices (AGA Medical, Golden Valley, MN) through our experience of over 14 years. Retrospective data review of patients from Rabin Medical Center who underwent Amplatzer occluder device placement between March 2007 and September 2021 for bronchopleural fistulae closure. In total, 72 patients had 83 Amplatzer occluder devices implanted for bronchopleural fistulae closure. The median age was 65.5 (interquartile range 56.0-72.3) years. The primary diseases were lung malignancy (48 [66.7%]) and thoracic infection (9 [12.5%]). Bronchopleural fistulae developed mainly following pneumonectomy (40.3%) and lobectomy (33.3%), with a median time from surgery to Amplatzer placement of 3.9 (interquartile range 1.4-16.4) months. We encountered no procedural or immediate postprocedural complications or deaths. Six months after Amplatzer insertion, there were 7 (8.4%) Amplatzer removals and 11 (15.3%) fistula-related deaths. Amplatzer occluders are a safe modality for nonsurgical bronchopleural fistulae management with ease of placement under moderate sedation and flexible bronchoscopy with good short- and long-term effectivity.