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Tunnel Vision: A Novel Approach for Blood Clot Retrieval Using Cryotherapy through a Flexible Bronchoscope
Fernando Figueroa Rodriguez1,2, Parminder Minhas1,2, Houssein A Youness1,2
1Interventional Pulmonary Program, Section of Pulmonary, Critical Care and Sleep Medicine, The University of Oklahoma Health Sciences Center, USA.
Abstract:
Cryoprobes inserted through a bronchoscope in the airways have frequently been used for the removal of foreign bodies and clots. We present a case of a 72-year-old man who presented with COVID-19 pneumonia and respiratory failure, requiring intubation and proning. During his stay, he developed pneumothoraces in the left hemithorax, which necessitated the placement of two large-bore chest tubes. However, the pneumothorax recurred. There was no air leak in either chest tube, and attempts to restore their patency through flushing or suctioning were unsuccessful. A disposable flexible bronchoscope was inserted into the chest tubes, allowing visualization of the source of occlusion and identification of a blood clot obstructing both tubes. These clots were successfully removed using a cryoprobe inserted through the working channel of the bronchoscope, leading to the restoration of chest tube patency and resolution of the pneumothorax.
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