Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Effectiveness of Ambulatory Tru-Close Thoracic Vent for the Outpatient Management of Pneumothorax: A Prospective Pilot Study

  • Kim, Yong Pyo (Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University Health System) ;
  • Haam, Seok Jin (Department of Cardiothoracic Surgery, Ajou University Hospital) ;
  • Lee, Sungsoo (Department of Cardiothoracic Surgery, Gangnam Severance Hospital, Yonsei University Health System) ;
  • Lee, Geun Dong (Department of Cardiothoracic Surgery, Gangnam Severance Hospital, Yonsei University Health System) ;
  • Joo, Seung-Moon (Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University Health System) ;
  • Yum, Tae Jun (Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University Health System) ;
  • Lee, Kwang-Hun (Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University Health System)
  • Received : 2016.11.05
  • Accepted : 2016.12.28
  • Published : 2017.06.01
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Abstract

Objective: This study aimed to assess the technical feasibility, procedural safety, and long-term therapeutic efficacy of a small-sized ambulatory thoracic vent (TV) device for the treatment of pneumothorax. Materials and Methods: From November 2012 to July 2013, 18 consecutive patients (3 females, 15 males) aged 16-64 years (mean: $34.7{\pm}14.9years$, median: 29 years) were enrolled prospectively. Of these, 15 patients had spontaneous pneumothorax and 3 had iatrogenic pneumothorax. A Tru-Close TV with a small-bore (11- or 13-Fr) catheter was inserted under bi-plane fluoroscopic assistance. Results: Technical success was achieved in all patients. Complete lung re-expansion was achieved at 24 hours in 88.9% of patients (16/18 patients). All patients tolerated the procedure and no major complications occurred. The patients' mean numeric pain intensity score was 2.4 (range: 0-5) in daily life activity during the TV treatment. All patients with spontaneous pneumothorax underwent outpatient follow-up. The mean time to TV removal was 4.7 (3-13) days. Early surgical conversion rate of 16.7% (3/18 patients) occurred in 2 patients with incomplete lung expansion and 1 patient with immediate pneumothorax recurrence post-TV removal; and late surgical conversion occurred in 2 of 18 patients (11.1%). The recurrence-free long-term success rate was 72.2% (13/18 patients) during a 3-year follow-up period from November 2012 to June 2016. Conclusion: TV application was a simple, safe, and technically feasible procedure in an outpatient clinic, with an acceptable long-term recurrence-free rate. Thus, TV could be useful for the immediate treatment of pneumothorax.

Keywords

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