University of Worcester Worcester Research and Publications

Use of 3-D navigation to target the site of autologous blood installation for lung volume reduction in bullous emphysema

Hetzel, J., Boeckeler, M., Lewis, Richard, Horger, M. and Haentschel, M. ORCID: (2020) Use of 3-D navigation to target the site of autologous blood installation for lung volume reduction in bullous emphysema. Chronic Respiratory Disease, 17 (1-4). p. 1479973120903556. ISSN 1479-9731

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Bronchoscopic lung volume reduction (BLVR) using intrabullous autologous blood instillation has been reported in single cases where other techniques are not possible. We present the use of three-dimensional navigation to instill autologous blood into emphysematous bullae for BLVR. A 62-year-old man presented with increasing dyspnea, due to emphysema with a conglomerate of giant bullae with two particularly large bullae. Surgical treatment was refused, so bronchoscopic autologous blood instillation into the bronchial segment leading to the large bullae was attempted, but was unsuccessful; blood failed to penetrate into the bullous cavity. Dyspnea worsened over the following year. We therefore performed another bronchoscopy and punctured a large bulla with a needle and created a tunnel from the central airways. Puncture position and direction were determined using a prototype of an electromagnetic navigation system. Under fluoroscopic guidance, a catheter was placed via the tunnel into the bulla and blood was instilled. This resulted in an almost complete shrinkage of the bullae, reduction of residual volume, and marked improvement in dyspnea within 4 months. To our knowledge, this is the first reported case of successful BLVR by navigated bronchoscopy with transbronchial puncture, dilatation, and autologous blood instillation into a giant bulla.

Item Type: Article
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The full-text of the online published article can be accessed via the official URL. This is an open access article under the CC-BY 4.0 licence (

Uncontrolled Discrete Keywords: Lung volume reduction, lung emphysema, 3-D navigation, bronchoscopic technique, hyperinflation
Divisions: College of Health, Life and Environmental Sciences > School of Science and the Environment
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Copyright Info: Open access article
SWORD Depositor: Prof. Pub Router
Depositing User: Karen Veitch
Date Deposited: 18 Feb 2020 10:07
Last Modified: 17 Jun 2020 17:34

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