Effectiveness of Ambulatory Tru-Close Thoracic Vent for the Outpatient Management of Pneumothorax: A Prospective Pilot Study.
10.3348/kjr.2017.18.3.519
- Author:
Yong Pyo KIM
1
;
Seok Jin HAAM
;
Sungsoo LEE
;
Geun Dong LEE
;
Seung Moon JOO
;
Tae Jun YUM
;
Kwang Hun LEE
Author Information
1. Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University Health System, Seoul 06273, Korea. doctorlkh@yuhs.ac
- Publication Type:Original Article
- Keywords:
Pneumothorax;
Thoracic vent;
Tru-Close;
Outpatient management
- MeSH:
Ambulatory Care Facilities;
Catheters;
Female;
Follow-Up Studies;
Humans;
Lung;
Outpatients*;
Pilot Projects*;
Pneumothorax*;
Prospective Studies*;
Recurrence
- From:Korean Journal of Radiology
2017;18(3):519-525
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: This study aimed to assess the technical feasibility, procedural safety, and long-term therapeutic efficacy of a small-sized ambulatory thoracic vent (TV) device for the treatment of pneumothorax. MATERIALS AND METHODS: From November 2012 to July 2013, 18 consecutive patients (3 females, 15 males) aged 16–64 years (mean: 34.7 ± 14.9 years, median: 29 years) were enrolled prospectively. Of these, 15 patients had spontaneous pneumothorax and 3 had iatrogenic pneumothorax. A Tru-Close TV with a small-bore (11- or 13-Fr) catheter was inserted under bi-plane fluoroscopic assistance. RESULTS: Technical success was achieved in all patients. Complete lung re-expansion was achieved at 24 hours in 88.9% of patients (16/18 patients). All patients tolerated the procedure and no major complications occurred. The patients' mean numeric pain intensity score was 2.4 (range: 0–5) in daily life activity during the TV treatment. All patients with spontaneous pneumothorax underwent outpatient follow-up. The mean time to TV removal was 4.7 (3–13) days. Early surgical conversion rate of 16.7% (3/18 patients) occurred in 2 patients with incomplete lung expansion and 1 patient with immediate pneumothorax recurrence post-TV removal; and late surgical conversion occurred in 2 of 18 patients (11.1%). The recurrence-free long-term success rate was 72.2% (13/18 patients) during a 3-year follow-up period from November 2012 to June 2016. CONCLUSION: TV application was a simple, safe, and technically feasible procedure in an outpatient clinic, with an acceptable long-term recurrence-free rate. Thus, TV could be useful for the immediate treatment of pneumothorax.
