A Pilot Study on the Feasibility of Interventional Lung Volume Reduction

• DOI: 10.1007/s00270-006-0211-8
• Publication Date: 2007-06-25T12:59:04Z
• Authors: Wansheng Wang; Yonghua Dong; Bin Liu; Chi Zhu; Yongqiang Yu
• Keywords: Ethanol; Bone Cements; Contrast Media; Iodized Oil; Pilot Projects; Balloon Occlusion; Radiology, Interventional; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Pulmonary Emphysema; Solvents; Animals; Feasibility Studies; Minimally Invasive Surgical Procedures; Rabbits; Pneumonectomy; Tomography, X-Ray Computed; Lung; Follow-Up Studies

The objective of this study was to evaluate the feasibility and safety of lung volume reduction by transbronchial alcohol and lipiodol suspension infusion with the aid of balloon-tipped catheter occlusion. Twenty-six healthy adult rabbits were divided into four treatment groups: alcohol and lipiodol suspension infusion (n = 8), lipiodol infusion (n = 8), alcohol infusion (n = 5), or bronchial lumen occlusion (n = 5). After selective lobar or segmental bronchial catheterization using a balloon-tipped occlusion catheter, the corresponding drug infusion was performed. Bone cement was used to occlude the bronchial lumen in the occlusion group. The animals were followed up for 10 weeks by chest X-ray and computed tomography (CT), and then the whole lungs were harvested for histological examination. Alcohol and lipiodol suspension or lipiodol could be stably retained in alveoli in the first two groups based on chest X-ray and CT, but obvious collapse only occurred in the group receiving alcohol and lipiodol suspension or the bronchial lumen occlusion group. Histological examination revealed damage and disruption of the alveolar epithelium and fibrosis in related lung tissue in the group receiving alcohol and lipiodol suspension. Similar changes were seen in the bronchial lumen occlusion group, apart from obvious marginal emphysema of the target areas in two animals. Interstitial pneumonia and dilated alveoli existed in some tissue in target areas in the lipiodol group, in which pulmonary fibrosis obliterating alveoli also occurred. Chronic alveolitis and pleural adhesion in target areas occurred in the group infused with alcohol alone, whereas visceral pleura of the other three groups was regular and no pleural effusion or adhesion was found. Alcohol and lipiodol suspension that is stably retained in alveoli can result in significant lung volume reduction. Through alcohol and lipiodol suspension infusion, obstructive emphysema or pneumonia arising from bronchial lumen occlusion could be avoided.