Abstract
Central airway obstruction (CAO) is seen in malignant and nonmalignant airway disorders
and can lead to significant morbidity and mortality. Endobronchial ablative therapies
are used in conjunction with mechanical debridement to achieve hemostasis and restore
airway patency. These therapies can be classified into modalities with immediate or
delayed effect. Therapies with immediate effect include heat therapies (such as electrocautery,
argon plasma coagulation, and laser) and cryorecanalization using a cryoprobe for
tissue extraction. These modalities can be used in severe CAO for immediate relief
of obstruction. Therapies with delayed effect include cryotherapy, brachytherapy,
and photodynamic therapy. These modalities should not be used for acutely symptomatic
CAO, and typically require follow-up bronchoscopy for removal of debris from the airway.
Multimodality approach typically leads to better outcomes.
Keywords
central airway obstruction - ablative therapy - electrocautery - argon plasma coagulation
- airway - laser - cryotherapy - brachytherapy - photodynamic therapy
