A Case of Pulmonary Bulla Volume Reduction by Transbronchial Puncture Under Electromagnetic Navigation Platform Combined With O-Arm CT Guidance

Pulmonary bullae are a common complication of chronic obstructive pulmonary disease (COPD), but treatment options are limited for patients with poor lung function and giant emphysematous bullae (GEB). We reported a case of a 61-year-old female with severe COPD complicated by a newly developed GEB. Using electromagnetic navigation technology, we precisely located and targeted the bronchi adjacent to the bullae within the lung. Guided by O-arm CT imaging, we punctured the bullae with a biopsy needle, evacuated the air, and administered autologous blood and thrombin. A follow-up pulmonary CT scan three days post-procedure revealed a significant reduction in the size of the giant bulla. Additionally, the patient's wheezing symptoms improved, and her performance on the 6-minute walk test showed some enhancement.