Occlusive endobronchial stent placement as a novel management approach to massive hemoptysis from lung cancer

Abstract

Massive hemoptysis in patients with advanced thoracic malignancies can be difficult to manage. Frequently, the bleeding source is not amenable to either bronchial artery embolization or surgical resection. Isolation of the bleeding source by endobronchial tamponade is an alternative management option. This is commonly achieved by the use of double-lumen endotracheal tubes or the placement of endobronchial balloons. Although effective, these approaches are not permanent solutions and may require prolonged intubation. We describe here an alternative, novel approach to endobronchial tamponade that does not require prolonged mechanical ventilation. We present a case in which massive hemoptysis from a left lower lobe cavitary lung cancer was successfully tamponaded and ultimately stopped by the placement of 2 covered self-expanding bronchial stents, allowing the patient to be extubated and to undergo further palliative therapy. No recurrent episodes of hemoptysis occurred throughout the patient's lifetime. Copyright © 2008 by the International Association for the Study of Lung.