Di Michiel James, Pan Corinna, Ing Alvin, Saghaie Tajalli
Department of Thoracic medicine Concord Repatriation General Hospital Sydney New South Wales Australia.
Faculty of Medicine and Health Sciences Macquarie University Sydney New South Wales Australia.
Respirol Case Rep. 2019 Jan 31;7(3):e00406. doi: 10.1002/rcr2.406. eCollection 2019 Apr.
Management of recurrent haemoptysis poses a difficult clinical scenario. TISSEEL (Baxter Healthcare Corporation Deerfield, IL, USA) is a fibrin sealant often used in surgery to aid control of bleeding. However, when endoscopic TISSEEL is used independently, migration, dislodgement, or even expectoration of the fibrin clot is a common complication that may lead to recurrence of haemoptysis. Here we describe two patients with recurrent haemoptysis in the context of malignancy who underwent bronchoscopy, during which they were managed with application of topical TISSEEL to the bleeding area, followed by deployment of an intrabronchial valve, followed by a further application of TISSEEL over the valve. The combination of TISSEEL and intrabronchial valve appeared to control haemoptysis and was resistant to expectoration or migration in these two cases. Thus, this combination may provide a safe and effective therapeutic option for the control of bronchial bleeding secondary to malignancy.
