Abstract
Pleural space diseases such as recurrent pleural effusion and pneumothorax inflict
a significant symptomatic burden on patients. Guidelines and studies are available
to guide best practices in the setting of refractory effusions, mostly in the setting
of malignancy, and recurrent pneumothorax. Less data is available to guide management
of refractory transudative effusions. Recurrent pleural effusions can be treated with
tunneled pleural catheters or catheter-based pleurodesis. While refractory transudative
effusions can benefit from tunneled pleural catheter, this is an area of ongoing research.
Regarding recurrent pneumothorax, video-assisted thoracoscopic surgery (VATS) pleurodesis
using mechanical or laser/argon beam coagulation is the most effective means of preventing
recurrence. Catheter based pleurodesis, a less invasive means of administering chemical
sclerosant via percutaneous thoracostomy tube, is only used when surgery is not an
option. However, both approaches induce inflammation of the pleural space, resulting
in adherence of the parietal and visceral pleura to prevent fluid or air re-accumulation.
This article will discuss catheter based chemical pleurodesis geared toward the interventional
radiologist, including a review of disease processes and indications, technique, and
strategies to mitigate complications as well as a literature review comparing percutaneous
chemical pleurodesis to other therapies.
Keywords
talc pleurodesis - tunneled pleural catheter - malignant effusion - spontaneous pneumothorax
- interventional radiology
