Tunneled pleural catheters for treatment of recurrent malignant pleural effusion following failed pleurodesis Journal Article


Authors: Thornton, R. H.; Miller, Z.; Covey, A. M.; Brody, L.; Sofocleous, C. T.; Solomon, S. B.; Getrajdman, G. I.
Article Title: Tunneled pleural catheters for treatment of recurrent malignant pleural effusion following failed pleurodesis
Abstract: PURPOSE: To evaluate patient outcomes when tunneled pleural drainage catheters are placed for symptomatic, recurrent malignant pleural effusion following failed chemical pleurodesis. MATERIALS AND METHODS: Two hundred seventy patients who underwent placement of a tunneled pleural catheter between January 2002 and December 2006 were retrospectively identified by reviewing interventional radiology billing records with institutional review board approval. Of these 270 patients, 63 (68 hemithoraces; 44 women, 19 men) with dyspnea were referred for tunneled pleural drainage catheter placement following failed pleurodesis for malignant pleural effusion. Clinical and procedural details were identified by chart review. Endpoints were technical success, symptomatic improvement in dyspnea, time to hospital discharge, and time to catheter removal or time to death with the catheter in place. RESULTS: Clinical improvement in dyspnea was noted in 60 of the 63 patients (95%). Fifty-seven of the 63 patients (90%) were discharged with their catheter in place after a median of 3 days (range, 0-29 days). Twenty-seven of the 63 patients (43%) were discharged in 2 days or less. Stays longer than 2 days were all associated with treatment of other medical problems. Twenty-one of the 68 catheters (31%) required fibrinolytic therapy for optimal evacuation of complex pleural collections. Eleven of the 68 catheters (16%) could subsequently be removed due to durable resolution of pleural effusion. The remaining patients died with catheters in place and no clinical evidence of catheter dysfunction after a median of 58 days. CONCLUSIONS: Even following failed pleurodesis, recurrent malignant pleural effusions can be effectively managed with placement of tunneled pleural catheters.
Keywords: adult; aged; aged, 80 and over; middle aged; treatment failure; clinical trial; methodology; recurrence; recurrent disease; pleura effusion; pleura tumor; pleural neoplasms; drainage; wound drainage; balloon dilatation; pleurodesis; pleural effusion
Journal Title: Journal of Vascular and Interventional Radiology
Volume: 21
Issue: 5
ISSN: 1051-0443
Publisher: Elsevier Science, Inc.  
Date Published: 2010-05-01
Start Page: 696
End Page: 700
Language: English
PUBMED: 20307992
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Anne Covey
    165 Covey
  2. Lynn Brody
    119 Brody
  3. Stephen Solomon
    422 Solomon