Cryorecanalization: keys to success

Symptomatic airway obstructions are common with endobronchial exophytic tumors and may result in lethal complications. Recently, a cryorecanalization procedure has emerged that plays a role in the immediate management of airway obstruction. This study was conducted to investigate the value of cryorecanalization for the immediate management of endobronchial obstructive pathology and to determine the factors that affect the success of the procedure.

We analyzed 40 patients with symptoms of airway obstruction who were admitted to our hospital from 2006 to 2010. Patients with exophytic stenosis due to primary bronchial or metastatic neoplasms who underwent cryorecanalization procedures were included. Patients were excluded if they had involvement of a major artery near the site of the intervention. The procedure was not performed on patients with coagulation abnormalities or thrombocyte count and aggregation problems. The data were collected retrospectively.

Successful cryorecanalization was achieved in 72.5 % of patients. We found that the success rate was mainly related to the presence of the distal involvement and the older age of obstruction. Restenosis rate was 17.2 %. [corrected] The mean survival time after the cryorecanalization procedure was 11 ± 12.7 months. No complications occurred in 14 patients. No severe bleeding was observed for any patients, and moderate hemorrhaging occurred in ten patients, which was stopped with an argon plasma coagulator. We experienced no intraoperative mortality.

Cryorecanalization is a successful and safe intervention for the immediate management of endobronchial stenosis. Appropriate patient selection and high success rates should be achieved after careful radiological assessments and with early management.