Skip to main content
SpringerLink
Log in

Evaluating Outcomes After Interventional Procedures

  • Chapter
  • First Online:
Interventions in Pulmonary Medicine

  • 1879 Accesses

Abstract

The location of the flow-limiting segment and airway mechanics are important points for guiding and estimating interventional bronchoscopy. Analysis of the flow–volume curve could be used in defining the nature of the stenosis and provide reliable information for evaluating the efficacy of stenting. However, flow–volume curves cannot identify the location of the lesion where airway resistance increases nor can it immediately define the outcome of stenting. By measuring lateral airway pressure on each side of the stenosis and plotting the two pressures against each other (pressure–pressure curve) during quiet breathing, the site of maximum obstruction and the degree of the stenosis can be determined quantitatively.

Measuring lateral airway pressures was found to be useful in assessing the nature of the stenosis and the outcome of intervention. This approach provides useful information in real time to guide treatment decisions such as additional procedures.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Seijo LM, Sterman DH. Interventional pulmonology. N Engl J Med. 2001;344:740–9.

    Article  PubMed  CAS  Google Scholar 

  2. Dawson SV, Elliott EA. Wave-speed limitation on expiratory flow a unifying concept. J Appl Physiol. 1977;43:498–515.

    PubMed  CAS  Google Scholar 

  3. Mead J. Expiratory flow limitation: a physiologist’s point of view. Fed Proc. 1980;39:2771–5.

    PubMed  CAS  Google Scholar 

  4. Miyazawa T, Yamakido M, Ikeda S, Furukawa K, Takiguchi Y, Tada H, Shirakusa T. Implantation of Ultraflex nitinol stents in malignant tracheobronchial stenoses. Chest. 2000;118:959–65.

    Article  PubMed  CAS  Google Scholar 

  5. Miyazawa T, Miyazu Y, Iwamoto Y, Ishida A, Kanoh K, Sumiyoshi H, Doi M, Kurimoto N. Stenting at the flow–limiting segment in tracheobronchial stenosis due to lung cancer. Am J Respir Crit Care Med. 2004;169:1096–102.

    Article  PubMed  Google Scholar 

  6. Pedersen OF, Ingram Jr RH. Configuration of maximum expiratory flow-volume curve: model experiments with physiological implications. J Appl Physiol. 1985;58:1305–13.

    PubMed  CAS  Google Scholar 

  7. Ohya N, Huang J, Fukunaga T, Toga H. Airway pressure-volume curve estimated by flow interruption during forced expiration. J Appl Physiol. 1989;67:2631–8.

    PubMed  CAS  Google Scholar 

  8. Pedersen OF. The Peak Flow Working Group: ­physiological determinants of peak expiratory flow. Eur Respir J. 1997;10:11–6.

    Google Scholar 

  9. Aljuri N, Freitag L, Vegegas JG. Modeling expiratory flow from excised tracheal tube law. J Appl Physiol. 1999;87:1973–80.

    PubMed  CAS  Google Scholar 

  10. Miller RD, Hyatt RE. Evaluation of obstructing lesions of the trachea and larynx by flow-volume loops. Am Rev Respir Dis. 1973;108:475–81.

    PubMed  CAS  Google Scholar 

  11. Brouns M, Jayaraju ST, Lacor C, Mey JD, Noppen M, Vincken W, Verbanck S. Tracheal stenosis: a flow dynamics study. J Appl Physiol. 2007;102:1178–84.

    Article  PubMed  Google Scholar 

  12. Nishine H, Hiramoto T, Kida H, Matsuoka S, Mineshita M, Kurimoto N, Miyazawa T. Assessing the site of maximum obstruction in the trachea using lateral pressure measurement during bronchoscopy. Am J Respir Crit Care Med. 2011;185:24–33.

    Article  Google Scholar 

  13. Mink S, Ziesmann M, Wood JDH. Mechanisms of increased maximum expiratory flow during HeO2 breathing in dogs. J Appl Physiol. 1979;47:490–502.

    PubMed  CAS  Google Scholar 

  14. Smaldone GC, Itoh H, Swift DL, Wagner HN. Effect of flow-limiting segments and cough on particle deposition and mucociliary clearance in the lung. Am Rev Respir Dis. 1979;120:747–58.

    PubMed  CAS  Google Scholar 

  15. Pedersen OF, Thiessen B, Lyager S. Airway compliance and flow limitation during forced expiration in dogs. J Appl Physiol. 1982;52:357–69.

    PubMed  CAS  Google Scholar 

  16. Macklem PT, Fraser RG, Bates DV. Bronchial pressures and dimensions in health and obstructive airway disease. J Appl Physiol. 1963;18:699–706.

    Google Scholar 

  17. Smaldone GC, Smith PL. Location of flow-limiting segments via airway catheters near residual volume in humans. J Appl Physiol. 1985;59:502–8.

    PubMed  CAS  Google Scholar 

  18. Pedersen OF, Brackel HJ, Bogaard JM, Kerrebijn KF. Wave-speed-determined flow limitation at peak flow in normal and asthmatic subjects. J Appl Physiol. 1997;83:1721–32.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Respiratory and Infectious Disease, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao Miyamae-ku, Kawasaki, Kanagawa, Japan

    Teruomi Miyazawa M.D. & Hiroki Nishine M.D.

Authors
  1. Teruomi Miyazawa M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroki Nishine M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Teruomi Miyazawa M.D. .

Editor information

Editors and Affiliations

  1. MD Anderson Cancer Center, Houston, TX, Department of Pulmonary Medicine, Bellvitge University Hospital, Barcelona, 08907, Spain

    Jose Pablo Díaz-Jimenez

  2. Clinica Y Maternidad Colon, Pulmonary Department, Mar Del Plata, Buenos Aires, 7600, Argentina

    Alicia N. Rodriguez

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Miyazawa, T., Nishine, H. (2013). Evaluating Outcomes After Interventional Procedures. In: Díaz-Jimenez, J., Rodriguez, A. (eds) Interventions in Pulmonary Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6009-1_5

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-6009-1_5

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6008-4

  • Online ISBN: 978-1-4614-6009-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation