Cryorecanalization: A new approach for the immediate management of acute airway obstruction

Objectives: Endobronchial cryotherapy is an established recanalization method for stenoses of the respiratory tract. However, previous applications of cryotherapy have not been immediately effective, requiring a second clean-up procedure several days later to finally obtain sufficient recanalization. In this study we demonstrate a newly developed cryoprobe allowing recanalization of tumor stenoses during a single intervention. Methods: In this prospective study flexible bronchoscopy was used for cryorecanalization of 60 patients with high-grade stenoses of the respiratory tract from exophytic tumors. Tumor tissue was frozen on the tip of the probe and subsequently removed from the surrounding respiratory tract tissue through retraction of the probe. Procedures were carried out on sedated, spontaneously breathing, intubated patients. Results: Fifty (83%) of 60 patients were successfully or partially successfully treated. Tumor bleeding occurred in 6 patients but was stopped with argon plasma coagulator treatment in all patients not requiring rigid bronchoscopy. Conclusion: Cryorecanalization with the newly developed cryoprobe permits effective, safe, and inexpensive therapy of endobronchial stenoses of the respiratory tract.