Direct EBUS ‐guided transtracheal lymphosclerosis for plastic bronchitis after Fontan
| Autor: | Jelena Hubrechts, Marc Gewillig, Geert Maleux, Christophe Dooms |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Magnetic resonance imaging General Medicine 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Lymphatic system Cyanoacrylate law Occlusion Subcarinal medicine Lipiodol Paratracheal Radiology Nuclear Medicine and imaging 030212 general & internal medicine Radiology Lymph Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Catheterization and Cardiovascular Interventions. 97 |
| ISSN: | 1522-726X 1522-1946 |
| Popis: | We report on a new puncture technique with direct transtracheal mediastinal lymphatic access to treat plastic bronchitis after Fontan repair. High resolution contrast-enhanced spiral CT identified enlarged lymph nodes in the paratracheal region. Inguinal intranodal Gadolinium Dynamic Contrast-enhanced Magnetic Resonance lymphangiography (DCMRL) confirmed the pathologic centrifugal lymph flow passing through these lymph nodes before leaking into the bronchial tree. The abnormal hypertrophic paratracheal, subcarinal, and hilar lymph nodes were punctured with a 22G needle through an endobronchial ultrasound bronchoscope. Occlusion of the lymph vessels was obtained by injecting a mixture of lipiodol/NBCA N-butyl cyanoacrylate (Histoacryl) 5/1 under fluoroscopic control. There was a total remission of PB with now 10 months of follow-up. |
| Databáze: | OpenAIRE |
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