Interventional therapy for symptomatic bronchial carcinoma

Symptoms such as dyspnoea, haemoptysis, coughing frequently occur in patients with bronchial carcinoma. Usually, central airway obstruction, pleural effusion or vena cava compression syndrome cause dyspnoea. Interventional bronchoscopy techniques, e.g. laser coagulation, electrocautery and cryosurgery offer very effective means for the re-canalisation of central airway obstruction. Stent placement and high-dose radiation brachytherapy are the procedures of choice for the treatment of extrinsic stenoses. The use of bronchoscopic coagulation, balloon catheters and embolisation of bronchial arteries may control severe haemoptysis. All interventional bronchoscopic techniques show symptomatic improvement and overall survival benefit in patients with bronchial carcinoma. Pleural involvement and effusion reflect progression of disease. Treatment consists of thoracoscopic talc pleurodesis and the use of various types of pleural catheters. Angiographic interventions (bronchial artery embolisation, dilatation and stenting of the vena cava superior) are needed for massive haemoptysis and the cava compression syndrome respectively.