Ambulatory Intrapleural Fibrinolytic Therapy in Highly Viscous Recurrent Malignant Pleural Effusion

Area of Science:

• Pulmonology
• Oncology
• Thoracic Surgery

Background:

• Malignant pleural effusion (MPE) is a frequent complication of lung cancer.
• Managing MPE, especially when highly viscous and recurrent, presents significant clinical challenges.
• Standard drainage methods may be ineffective for viscous effusions.

Observation:

• A case of recurrent, highly viscous MPE in a lung cancer patient is presented.
• Initial attempts at drainage using standard catheters and drains were unsuccessful due to high viscosity.
• Intrapleural fibrinolytic therapy was required for successful evacuation.

Findings:

• A single dose of intrapleural fibrinolysis effectively evacuated the viscous effusion.
• This treatment was repeated 13 times over 12 months in an ambulatory setting.
• No bleeding complications were noted during the repeated treatments.

Implications:

• Repeated intrapleural fibrinolysis is a feasible and safe management strategy for highly viscous recurrent MPE.
• Ambulatory treatment with intrapleural fibrinolysis can improve patient quality of life.
• This approach may reduce hospitalizations for patients with complex malignant pleural effusions.