Temporary Right Middle Lobe Occlusion with a Blocking Device to Enable Collateral Ventilation Measurement of the Right Major Fissure.

Respiration; International Review of Thoracic Diseases
Jorrit B A WellingDirk-Jan Slebos

Abstract

Absence of interlobar collateral ventilation is essential to achieve lobar volume reduction after endobronchial valve (EBV) treatment and can be assessed using the Chartis measurement. However, especially in lower lobe measurements, Chartis can be complicated by the "no-flow phenomenon", during which a sudden cessation of flow is observed, leading to an unreliable measurement. If this phenomenon occurs in the right lower lobe, when measuring collateral flow over the right major fissure, the entrance to the right middle lobe should be occluded, and the Chartis balloon should be placed in the right upper lobe. Both Watanabe spigots and balloon catheters can be used to achieve occlusion. Our aim was to demonstrate that right middle lobe occlusion with a blocking device is helpful in obtaining a reliable Chartis outcome in case of the no-flow phenomenon in the right lower lobe. We performed a retrospective analysis of patients scheduled for EBV treatment in an EBV registry between September 2016 and September 2019. We included 15 patients with severe emphysema (median age 63 years [range 47-73], 73% female, and FEV1 24% [range 19-36] of predicted), who required temporary middle lobe occlusion (12 Watanabe spigot, 3 balloon catheter...Continue Reading

References

May 5, 2012·The European Respiratory Journal·Felix J F HerthDirk-Jan Slebos
Dec 18, 2013·Thorax·Wolfgang GesierichJuergen Behr
Dec 10, 2015·The New England Journal of Medicine·Karin KloosterDirk-Jan Slebos
Apr 15, 2016·The European Respiratory Journal·Wolfgang GesierichJuergen Behr
Apr 26, 2016·International Journal of Chronic Obstructive Pulmonary Disease·Theodoor David Koster, Dirk-Jan Slebos
Dec 20, 2016·Respiration; International Review of Thoracic Diseases·Dirk-Jan SlebosArschang Valipour
Sep 16, 2017·Respirology : Official Journal of the Asian Pacific Society of Respirology·Jorrit B A WellingDirk-Jan Slebos
May 23, 2018·American Journal of Respiratory and Critical Care Medicine·Gerard J CrinerUNKNOWN LIBERATE Study Group

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Citations

Aug 28, 2020·Expert Review of Respiratory Medicine·T David KosterDirk-Jan Slebos
Jul 30, 2021·ERJ Open Research·T David KosterDirk-Jan Slebos

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