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Volume 131, Issue 1, Pages (January 2007)

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Presentation on theme: "Volume 131, Issue 1, Pages (January 2007)"— Presentation transcript:

1 Volume 131, Issue 1, Pages 261-274 (January 2007)
State of the Art  Wahidi Momen M. , MD, FCCP, Herth Felix J.F. , MD, FCCP, Ernst Armin , MD, FCCP  CHEST  Volume 131, Issue 1, Pages (January 2007) DOI: /chest Copyright © 2007 The American College of Chest Physicians Terms and Conditions

2 Figure 1 The curves depict the increasing number of rigid bronchoscopies (green) performed in an interventional pulmonary practice (Beth Israel Deaconess Medical Center) over several years. The increase in the number of bronchoscopies is mirrored by the general increase in flexible bronchoscopic interventional procedures (red) performed over the same period of time. OR = operating room; PSPU = pulmonary special procedures unit. CHEST  , DOI: ( /chest ) Copyright © 2007 The American College of Chest Physicians Terms and Conditions

3 Figure 2 Granulation tissue is visible at the proximal end of a tracheal stent (top left). The tissue is coagulated with the help of argon plasma. The ignited arc working in a noncontact mode is seen (top right). The necrotic tissue (bottom left) is debrided mechanically with the help of large forceps (bottom right). CHEST  , DOI: ( /chest ) Copyright © 2007 The American College of Chest Physicians Terms and Conditions

4 Figure 3 Top,A: a proximal view of a silicone stent within the right mainstem bronchus.Bottom,B: a distal view of a silicone stent within the bronchus intermedius. CHEST  , DOI: ( /chest ) Copyright © 2007 The American College of Chest Physicians Terms and Conditions

5 Figure 4 Top,A: squamous cell carcinoma with near complete occlusion of the left mainstem bronchus.Bottom,B: left mainstem bronchus after mechanical resection of the tumor tissue and placement of a metallic stent CHEST  , DOI: ( /chest ) Copyright © 2007 The American College of Chest Physicians Terms and Conditions

6 Figure 5 A patient with a small endobronchial carcinomain situ. The white-light endoscopy (top,A) shows small raised lesions; they are much more clearly visible with the help of AFB (bottom,B). CHEST  , DOI: ( /chest ) Copyright © 2007 The American College of Chest Physicians Terms and Conditions

7 Figure 6 Image of a transbronchial needle puncture of a small lymph node in the 10R position. The needle is guided by EBUS through a dedicated EBUS endoscope. A Doppler function clearly shows the neighboring vessel. CHEST  , DOI: ( /chest ) Copyright © 2007 The American College of Chest Physicians Terms and Conditions

8 Figure 7 Nodules seen on the diaphragmatic pleura during medical pleuroscopy in a patient who presented with a right pleural effusion. The biopsy specimen showed adenocarcinoma cells that were consistent with an ovarian origin. CHEST  , DOI: ( /chest ) Copyright © 2007 The American College of Chest Physicians Terms and Conditions

9 Figure 8 View of endobronchial one-way valves placed into the airways of a patient with heterogeneous emphysema. CHEST  , DOI: ( /chest ) Copyright © 2007 The American College of Chest Physicians Terms and Conditions

10 Figure 9 Axial CT scan image of a patient with a high-grade tracheal obstruction due to adenoid cystic carcinoma (top,A). The three-dimensional reconstruction (bottom,B) gives a much better understanding of the extent of the lesion, and allows for improved procedural and surgical planning. CHEST  , DOI: ( /chest ) Copyright © 2007 The American College of Chest Physicians Terms and Conditions

11 Figure 10 Typical images of an electromagnetically guided (superDimension) transbronchial lung biopsy. The parenchymal lesion is visible in sagittal, coronal, and axial views. The forward view in the lower right-hand corner gives the “bulls-eye” image when the targeted lesion is reached. CHEST  , DOI: ( /chest ) Copyright © 2007 The American College of Chest Physicians Terms and Conditions

12 Figure 11 Narrow band image of an endobronchial severe dysplasia. Observe the clearly visible microvascular abnormalities. CHEST  , DOI: ( /chest ) Copyright © 2007 The American College of Chest Physicians Terms and Conditions


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