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Balloon Bronchoplasty for the Treatment of Bronchial Stenosis After Lung Transplantation: A Single-Center 10-Year Experience

 Dong Kyu Kim  ;  Joon Ho Kwon  ;  Kichang Han  ;  Man-Deuk Kim  ;  Gyoung Min Kim  ;  Sungmo Moon  ;  Juil Park  ;  Jong Yun Won  ;  Hyung Cheol Kim  ;  Sei Hyun Chun  ;  Seung Myeon Choi 
 KOREAN JOURNAL OF RADIOLOGY, Vol.24(5) : 424-433, 2023-05 
Journal Title
Issue Date
Angioplasty, Balloon* ; Bronchi / diagnostic imaging ; Bronchi / surgery ; Bronchial Diseases* / diagnostic imaging ; Bronchial Diseases* / etiology ; Bronchial Diseases* / surgery ; Constriction, Pathologic / surgery ; Humans ; Lung Transplantation* / adverse effects ; Retrospective Studies ; Treatment Outcome
Balloon dilatation ; Bronchial stenosis ; Early-stage treatment ; Lung transplantation ; Prolonged dilatation
Objective: To assess the safety and efficacy of balloon dilatation under dual guidance using fluoroscopy and bronchoscopy for treating bronchial stenosis following lung transplantation (LT), and to elucidate the factors associated with patency after the procedure.

Materials and Methods: From September, 2012, to April, 2021, 50 patients (mean age ± standard deviation, 54.4 ± 12.2 years) with bronchial stenosis among 361 recipients of LT were retrospectively analyzed. The safety of balloon dilatation was assessed by evaluating procedure-related complications. Efficacy was assessed by evaluating the technical success, primary patency, and secondary patency. Primary and secondary cumulative patency rates were calculated using the Kaplan-Meier method. The factors associated with patency after the procedure were evaluated using multivariable Cox hazard proportional regression analysis.

Results: In total, 65 bronchi were treated with balloon dilatation in 50 patients. The total number of treatment sessions was 277 and the technical success rate was 99.3% (275/277 sessions). No major procedure-related complications were noted. During the mean follow-up period of 34.6 ± 30.8 months, primary patency was achieved in 12 of 65 bronchi (18.5%). However, the patency rate improved to 76.9% (50 of 65 bronchi) after repeated balloon dilatation (secondary patency). The 6-month, 1-year, 3-year, and 5-year secondary patency rates were 95.4%, 90.8%, 83.1%, and 78.5%, respectively. The presence of clinical symptoms was a significant prognostic factor associated with reduced primary patency (adjusted hazard ratio [HR], 0.465; 95% confidence interval [CI], 0.220–0.987). Early-stage treatment ≤ 6 months (adjusted HR, 3.588; 95% CI, 1.093– 11.780) and prolonged balloon dilatation > 5 min (adjusted HR, 3.285; 95% CI, 1.018–10.598) were associated with significantly higher secondary patency.

Conclusion: Repeated balloon dilatation was determined to be safe and effective for treating bronchial stenosis following LT. Early-stage treatment and prolonged balloon dilatation could significantly promote long-term patency.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Joon Ho(권준호) ORCID logo
Kim, Gyoung Min(김경민) ORCID logo
Kim, Dong Kyu(김동규) ORCID logo
Kim, Man Deuk(김만득) ORCID logo
Kim, Hyung Cheol(김형철)
Moon, Sungmo(문성모)
Park, Juil(박주일)
Won, Jong Yun(원종윤) ORCID logo
Han, Ki Chang(한기창) ORCID logo
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