RT Journal Article
SR Electronic
T1 Novel use of paclitaxel-coated balloons in refractory non-anastomotic airway stenosis following lung transplantation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2675
VO 42
IS Suppl 57
A1 Mark Greer
A1 Thomas Fühner
A1 Martin Dierich
A1 Gregor Warnecke
A1 Axel Haverich
A1 Tobias Welte
A1 Jens Gottlieb
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P2675.abstract
AB Introduction: Airway stenosis (AS) is the commonest airway complication after lung transplantation (LuTx) [1,2]. Treatment outcomes are disappointing due to high recurrence rates. Re-canalization is performed using argon photocoagulation (APC) and balloon dilatation (BD) with luminal patency being maintained by stents, localised brachytherapy or topical mitomycin. Paclitaxel-coated balloons (PCB) are used in coronary artery stenosis [3,4] and we aimed to evaluate similar PCBs in refractory airway stenosis after LuTx.Methods: Patients with recurrent AS under conventional treatment between 01.11.2011 and 01.11.2012 were recruited. Written consent and individual ethics committee approval was obtained prior to PCB. Dilatation was performed under light sedation using flexible bronchoscopy.Results: One heart-lung transplant and 8 double-lung transplant patients underwent PCB dilatation. Stenoses occurred 72 [IQR 37-77] days post-transplant, with previous treatment extending over 325 [IQR 274-394] days, requiring 20 [IQR 16-23] interventions. Three patients remained intervention-free 143 [IQR 128-201] days after PCB. Two patients were managed conservatively after re-stenosis, one being re-transplanted for chronic allograft dysfunction. All other patients continued APC in unaltered treatment intensity. One guide-wire related pneumothorax arose during PCB-dilatation, otherwise no complications occurred.Conclusion: Paclitaxel-coated balloons offer a viable treatment option in managing recurrent non-anastomotic AS following LuTx. Medium term efficacy appears comparable with current treatments. Larger prospective studies are required.