Case of Life-Threatening Gas Embolism Associated With Argon Plasma Coagulation

CHEST Journal ◽  
2010 ◽  
Vol 138 (4) ◽  
pp. 116A
Author(s):  
Samaan Rafeq ◽  
Sugantha Sundar ◽  
Armin Ernst ◽  
Adnan Majid
Keyword(s):  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Gas Embolism ◽  
Plasma Coagulation ◽  
Life Threatening

Argon Plasma Coagulation: Elucidation of the Mechanism of Gas Embolism

Respiration ◽  
2021 ◽  
pp. 1-5
Author(s):  
Erik E. Folch ◽  
Catherine L. Oberg ◽  
Atul C. Mehta ◽  
Adnan Majid ◽  
Colleen Keyes ◽  
...  
Keyword(s):  
Direct Contact ◽  
Gas Flow ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Tracheobronchial Tree ◽  
Bleeding Complications ◽  
Gas Transfer ◽  
Gas Embolism ◽  
Associated Gas ◽  
Plasma Coagulation

<b><i>Background:</i></b> Argon plasma coagulation (APC) is a tool used in the management of tracheobronchial obstruction or bleeding. Complications include gas embolism which can cause devastating effects including hemodynamic instability, cardiac arrest, and stroke. Multiple theories as to how gas embolism occurs with APC have been postulated; however, none have identified the exact mechanism. <b><i>Objectives:</i></b> To identify the mechanism by which APC causes gas embolism in the tracheobronchial tree. <b><i>Methods:</i></b> Using an explanted porcine tracheobronchial tree with lung parenchyma, the APC catheter was applied through noncontact and direct contact to the endobronchial airway mucosa via flexible bronchoscopy. This was done at multiple gas flow settings and pulse durations. Visual changes in the mucosa were photographed, videoed, and described. <b><i>Results:</i></b> Gross evidence of submucosal gas transfer occurred when the APC catheter was in direct contact with the mucosa at all gas flow settings in all applications, despite using shorter pulse durations. Whenever the catheter was not in contact with the mucosa, there was no transfer of gas at any gas flow setting or pulse duration. <b><i>Conclusions:</i></b> Direct mucosal contact with the APC probe leads to submucosal gas deposition and is a likely mechanism for gas entry into the intravascular space. In reported cases of APC-associated gas embolism, presence of a vascularized endobronchial tumor may have increased the risk of gas tracking into the intravascular space. Care should be taken when applying APC during brisk bleeding or limited vision, as inadvertent mucosal contact may occur and could increase the risk of gas embolism.

Treatment of recurrent respiratory papillomatosis with argon plasma coagulation

1997 ◽  
Vol 111 (4) ◽  
pp. 381-384 ◽  
Author(s):  
W. Bergler ◽  
M. Hönig ◽  
K. Götte ◽  
G. Petroianu ◽  
K. Hörmann
Keyword(s):  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Good Control ◽  
Flexible Endoscopy ◽  
Recurrent Respiratory Papillomatosis ◽  
Lower Airway ◽  
Plasma Coagulation ◽  
Difficult Condition ◽  
Life Threatening ◽  
First Time

AbstractExtension of recurrent respiratory papillomatosis (RRP) to the lower airway in children is life-threatening and an extremely difficult condition to treat. We present the case of a seven-year-old girl with progressive RRP since the age of two. Repeated CO2 laser treatment and interferon-alpha treatment could not prevent tracheotomy and spread to the trachea. We used argon plasma coagulation (APC) with flexible endoscopy for the first time for the treatment of RRP. APC gives a controlled limited penetration into the tissue and good control of bleeding. There is no carbonization or vaporization which makes it a suitable method for the treatment of lower airway RRP. After a few treatments with APC, we gained very good control of the disease with no side-effects or complications. The described application of APC seems to be a promising way to treat lower airway RRP.

scholarly journals Cerebral Gas Embolism from Bronchoscopic Argon Plasma Coagulation: A Case Report

Respiration ◽  
2012 ◽  
Vol 83 (3) ◽  
pp. 267-270 ◽  
Author(s):  
Yasmeen Shaw ◽  
Ken Y. Yoneda ◽  
Andrew L. Chan
Keyword(s):  
Case Report ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Gas Embolism ◽  
Plasma Coagulation

scholarly journals Secondary pulmonary malignancies requiring interventional bronchoscopic procedures

2021 ◽  
Vol 29 (3) ◽  
pp. 360-369
Author(s):  
Efsun Gonca Uğur Chousein ◽  
Demet Turan ◽  
Mehmet Akif Özgül ◽  
Erdoğan Çetinkaya
Keyword(s):  
Airway Obstruction ◽  
Clinical Characteristics ◽  
Argon Plasma Coagulation ◽  
Survival Rates ◽  
Argon Plasma ◽  
Shortness Of Breath ◽  
Airway Patency ◽  
Plasma Coagulation ◽  
Life Threatening ◽  
The Mean

Background: In this study, we aimed to share our singlecenter experience and to investigate the effect of interventional bronchoscopic procedures on secondary pulmonary malignancies in terms of complications, success, and survival rates. Methods: A total of 83 patients (42 males, 41 females; mean age: 57.8±15.2 years; range, 18 to 94 years) with secondary pulmonary malignancies who underwent interventional bronchoscopic procedures between January 2009 and December 2019 were retrospectively reviewed. Data including demographic and clinical characteristics of the patients, complications, and success and survival rates were recorded. Results: The most common secondary pulmonary malignancies were kidney and thyroid tumors with the complaints of cough, shortness of breath, and hemoptysis. The mean duration before the diagnosis was 34.7±52.8 (range, 0.1 to 219.3) months, and the mean survival after the diagnosis were 10±13.1 (range, 0.2 to 44.4) months. A total of 92% of the patients had an airway obstruction of >50% and the interventional bronchoscopic procedures such as argon plasma coagulation, laser, cryo, and mechanical resection were successful in achieving airway patency. Laser application was found to significantly improve survival (p=0.015). Acute complication rate was 8.4% and mortality rate was 0%. Conclusion: In patients with tracheobronchial lesions due to secondary pulmonary malignancies, interventional bronchoscopic procedures, regardless of the stage of the disease, provide rapid palliation in life-threatening symptoms such as dyspnea and hemoptysis due to airway obstruction, prolonging patient"s survival and gain time for additional treatments to take effect for primary disease.

GAS EMBOLISM WITH THE USE OF BRONCHOSCOPIC ARGON PLASMA COAGULATION

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 39S
Author(s):  
Dilip Nataraj ◽  
Adnan Majid ◽  
Feroze Mahmood ◽  
Saleh Alazemi ◽  
David M. Berkowitz ◽  
...  
Keyword(s):  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Gas Embolism ◽  
Plasma Coagulation

scholarly journals Hemospray® during Emergency Endoscopy: Indonesia’s First Experience from 37 Patients

2020 ◽  
Vol 14 (1) ◽  
pp. 70-79
Author(s):  
Muhammad Begawan Bestari ◽  
Ignatius Ronaldi Joewono ◽  
Dolvy Girawan ◽  
Jefry Tahari Argatio ◽  
Siti Aminah Abdurachman
Keyword(s):  
Mortality Rate ◽  
Gastrointestinal Bleeding ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Primary Treatment ◽  
Emergency Endoscopy ◽  
Plasma Coagulation ◽  
Life Threatening ◽  
Cook Medical ◽  
Hemostatic Powder

Gastrointestinal bleeding (GIB) is one of the main indications for performing endoscopy; this condition can be life threatening. In some cases, emergency endoscopy (EE) is necessary to identify the source and stop the bleeding. Recently, hemostatic powder was introduced, one of which was Hemospray® (Cook Medical, Winston-Salem, NC, USA), which showed promising results for rapid hemostasis in primary treatment and salvage when conventional methods fails. Samples were taken retrospectively for a duration of 3 years since Hemospray was first introduced in Indonesia, from January 2016 to January 2019. The total number of EEs that used Hemospray were 37 procedures for 37 patients; 21 (56.8%) were males and 16 (43.2%) were females, while the average age was 67.8 years. Hemospray was used for upper GIB in 30 cases (81.1%) and for lower GIB in 7 (18.9%). Hemospray was used as monotherapy for 24 patients (64.9%) and as secondary modality for 13 (35.1%). The primary treatment was argon plasma coagulation in 8 cases (21.6%), adrenaline in 4 (10.8%), and Histoacryl® in 1 (2.7%). The mortality rate was 37.8% (n = 14); most deaths occurred within 30 days after the EE was performed, and none of the deaths was related to endoscopy or GIB. Hemospray was able to achieve hemostasis in all cases. Furthermore, there was no event of rebleeding. When conventional modalities alone were inadequate, the combination with Hemospray appeared to be able to control the bleeding. One of the main advantages of Hemospray is the ease in reaching difficult areas, and it require less skill compared to conventional modalities.

scholarly journals Cardiac Arrest due to Left Ventricular Gas Embolism After Bronchoscopic Argon Plasma Coagulation: A Case Report

2007 ◽  
Vol 14 (1) ◽  
pp. 33-35 ◽  
Author(s):  
Yaron Goldman ◽  
Peter J. Panzica ◽  
Duane S. Pinto ◽  
Ralph Delatorre ◽  
David Feller-Kopman ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Case Report ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Left Ventricular ◽  
Gas Embolism ◽  
Plasma Coagulation

Gas Embolism Following Bronchoscopic Argon Plasma Coagulation

CHEST Journal ◽  
2008 ◽  
Vol 134 (5) ◽  
pp. 1066-1069 ◽  
Author(s):  
Chakravarthy Reddy ◽  
Adnan Majid ◽  
Gaetane Michaud ◽  
David Feller-Kopman ◽  
Ralph Eberhardt ◽  
...  
Keyword(s):  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Gas Embolism ◽  
Plasma Coagulation

Endoscopic mucosal resection for recurrent gastric antral vascular ectasia

VASA ◽  
2008 ◽  
Vol 37 (3) ◽  
pp. 289-292 ◽  
Author(s):  
Katsinelos ◽  
Chatzimavroudis ◽  
Katsinelos ◽  
Panagiotopoulou ◽  
Kotakidou ◽  
...  
Keyword(s):  
Endoscopic Mucosal Resection ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Deficiency Anemia ◽  
Gastric Antral Vascular Ectasia ◽  
Therapeutic Approaches ◽  
Plasma Coagulation ◽  
Vascular Ectasia ◽  
Mucosal Resection ◽  
First Case

Gastric antral vascular ectasia (GAVE) is an overt or occult source of gastrointestinal bleeding. Despite several therapeutic approaches have been successfully tested for preventing chronic bleeding, some patients present recurrence of GAVE lesions. To the best of our knowledge, we report the first case, of a 86-year-old woman who presented severe iron-deficiency anemia due to GAVE and showed recurrence of GAVE lesion despite the intensive argon plasma coagulation treatment. We performed endoscopic mucosal resection of bleeding GAVE with resolution of anemia.

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