Endobronchial closure of postoperative bronchopleural fistula with embolization coils: a sandwich-like approach

<bold>Objective:</bold> We aimed to specify the imaging characteristics of postoperative bronchopleural fistulas (BPFs) and present our experience treating them with pushable embolization coils. <bold>Methods:</bold> Six consecutive patients (4 males and 2 females aged 29–56 years) with postoperative BPF who received the bronchoscopic treatment with the pushable Nester® Embolization Coil (Cook Medical, Bloomington, Indiana) as we described were included in this single-center, retrospective study. Multichoplanar reconstruction of CT scans were reviewed for the fistula’s existence, location, size, and radiological complications. Using standardized data abstraction forms, demographic traits and clinical outcomes were extracted from the medical files of these patients. <bold>Results:</bold> CT identified the presence of postoperative BPF and its other radiological characteristics in all patients. The angioplasty catheter-based procedure allows the precise occlusion of the fistula “like a sandwich” with the pushable Embolization Coils. Five patients with BPF sizes ranging from 0.8 to 1.5 mm were successfully treated by the pushable Embolization Coils, except for one patient with a BPF size of 5.8 mm. No adverse events or complications were observed throughout the follow-up, ranging from 29 to 1307 days. <bold>Conclusions:</bold> The pushable Nester® Embolization Coils seem a minimally invasive, cost-effective, and relatively easy-to-perform bronchoscopic treatment for postoperative BPFs with sizes < 2mm.