Role of Interventional Radiology in Management of Chest Tubes After Endobronchial Valve Deployment

Sunday, March 5, 2023

3:54 PM – 4:03 PM

Location: Phoenix Convention Center, 225AB

Presenting Author(s)

Suprit C. Singh, MD

Resident
Temple University Hospital

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

EM

Elen G. Mussie, B.A.

Medical Student
Lewis Katz School of Medicine at Temple University
AH

Adina S. Harris, B.A.

Medical Student
Lewis Katz School of Medicine at Temple University
JM

Jared Meshekow, MD MPH

Clinical Assistant Professor, Vascular and Interventional Radiology
Temple University Hospital
EC

Emily Cuthbertson, MD

Clinical Associate Professor, Interventional Radiology
Temple University Hospital

Disclosure(s):

Suprit C. Singh, MD: No financial relationships to disclose

Purpose: The purpose of this study is to compare chest tubes placed in patients who develop pneumothoraces after endobronchial valve (EBV) placement with tubes placed for pneumothoraces from other etiologies. As EBV placement is becoming more common, it is important to understand the nuances in managing these patients.

Materials and Methods: This is a retrospective study involving non-pregnant, adult patients who had chest tubes placed for pneumothoraces by IR at an academic institution between January 2011 and September 2021. Using the EMR, data was compiled into a database and patients were divided by pneumothorax etiology, including EBV placement, iatrogenic, lung disease, malignancy, and trauma. Demographics, comorbidities, and additional care required after tube placement were collected. Characteristics of chest tube placement including number, size, duration, and if additional tube manipulations were required after placement were collected.

Results:
A total of 197 patients were recorded, 39% female and 61% male, with a mean age of 57 years old. These patients were broken down into pneumothorax causes: EBV deployment (19%), surgery (42%), lung disease (12%), malignancy (3%), and trauma (24%). Mean size of chest tubes placed due to EBV deployment, iatrogenic causes, lung disease, malignancy, and trauma were 16, 11, 13, 14, and 12 French, respectively. Mean duration of chest tubes placed due to EBV deployment, iatrogenic causes, lung disease, malignancy, and trauma were 12, 4, 8, 9, and 6 days, respectively. 44% of patients post EBV deployment required further manipulation of their chest tube, while the percentage of patients requiring manipulation who developed pneumothoraces from other etiologies ranged from 0-13% (Table 1).

Conclusion:
Patients who had pneumothoraces post EBV deployment more frequently required more than one chest tube, with larger chest tubes, on average, compared to other etiologies. In addition, chest tubes in post EBV patients had longer average durations and required more interventions to resolve pneumothoraces compared to other etiologies.