Interventional Pulmonology 2012

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OBJECTIVES• Introduce Interventional Pulmonology• Review advances in diagnostic techniques• Discuss ablative technologies• Clinical applicability of InterventionalPulmonology in the management ofobstructive lung disease• Future applications of technology
THE HUMAN LUNG• 22-24 generations• >100,000 bronchi,bronchioles• 2400 km (1500 miles)of airways• 300-500 million alveoli• 0.3mm in diameter• Surface area 70m2• Capillaries 992 km(616 miles) end to endDetroit to Key WestDetroit to New York CityMichael J. Simoff, M.D.
Page 1: INTERVENTIONAL PULMONOLOGYFOR LUNG
Page 5 and 6: LUNG CANCER MORTALITY: WOMEN
Page 7 and 8: STAGING• The purpose of staging i
Page 9 and 10: WHITE LIGHT BRONCHOSCOPYSuperficial
Page 11 and 12: FLUOROPHORES / AUTOFLUORESCENCE•
Page 13: MICROINVASIVE CARCINOMAWhite LightA
Page 16 and 17: CROSS SECTIONAL ANATOMY
Page 18 and 19: EBUS - ANATOMYMichael J. Simoff, M.
Page 20 and 21: ENDOBRONCHIAL ULTRASOUND• Evaluat
Page 22 and 23: EBUS and AIRWAYS
Page 24 and 25: TUMOR INVASION OR IMPRESSION
Page 26 and 27: CURRENT USE OF TBNA• 11.8% routin
Page 28 and 29: EBUS GUIDED TBNA
Page 31 and 32: EBUS-TBNA at HFH• Last 30 EBUS-TB
Page 33 and 34: THE SOLITARY PULMONARY NODULEX-ray
Page 35 and 36: TRANSBRONCHIAL BIOPSY OF SPN• Per
Page 37 and 38: CT FLUOROSCOPYInvasive Poorly Diffe
Page 39 and 40: PERIPHERALULTRASOUND
Page 41 and 42: NAVIGATIONLocatable Guide
Page 44 and 45: Michael J. Simoff, M.D.
Page 46 and 47: BRONCHOSCOPY FORSOLITARY PULMONARY
Page 49 and 50: THERAPEUTICS - BENIGN DISEASE• Tr
Page 51: AIRWAY OBSTRUCTIONINTRINSIC EXTRINS
Page 54 and 55:
THERAPEUTIC TECHNIQUES• Silastic
Page 56 and 57:
RIGID BRONCHOSCOPY
Page 58 and 59:
LASER• 84-92% symptom palliation
Page 61 and 62:
ELECTROCAUTERY• Monopolar highfre
Page 64:
ARGON PLASMA COAGULATION• Ionized
Page 67 and 68:
CRYOTHERAPY• Tissue destruction a
Page 70 and 71:
PHOTODYNAMIC THERAPY24-36 hours48 h
Page 72 and 73:
STENTING• Exchange one chroniccon
Page 74 and 75:
SILASTIC STENTS• Removable• No
Page 76 and 77:
METALLIC STENTS• Favorable wall/i
Page 78 and 79:
RUSCH-Y STENT• Hybrid- Silicone-
Page 80 and 81:
BALLOON DILATATION• Rigid broncho
Page 82 and 83:
• Endobronchialadhesive• Used f
Page 84 and 85:
MEDICAL THORACOSCOPY• 67 Year old
Page 86 and 87:
MULTIMODALITY THERAPYMost disorders
Page 88 and 89:
MULTIMODALITY THERAPY:ENDOBRONCHIAL
Page 90 and 91:
THE FUTURE
Page 92 and 93:
SOLITARY PULMONARY NODULES
Page 94 and 95:
THE FUTURE:THE WAY WE SEE THINGS•
Page 96 and 97:
CONFOCAL MICROENDOSCOPY• Blue lig
Page 98 and 99:
Tomophase Optical Tissue Analyzer I
Page 100 and 101:
ElectrosurgeryMetal StentsRigid Bro
Page 102 and 103:
DIAGNOSTIC INTERVENTIONAL PULMONOLO
Page 104 and 105:
LASER• Light amplification bystim
Page 106 and 107:
BRONCHOSCOPIC TREATMENTSFOR EMPHYSE
Page 108:
FUTURE
Page 111:
CONTACT INFORMATIONMichael Simoff,
Page 114 and 115:
RADIOLOGY FOR BENIGN DISEASEInspira
Page 116 and 117:
EBUS AND THE DIAGNOSIS OF CANCERDis
Page 118 and 119:
GENE THERAPYDan Sterman, MD
Page 120 and 121:
STAGING - TNMMountain, Dresler. Che
Page 122 and 123:
ANATOMIC CHANGES INPREINVASIVE LUNG
Page 124 and 125:
BRACHYTHERAPY• 20-40 Gy delivered
Page 126 and 127:
COPD• Emphysema, chronicbronchiti
Page 128 and 129:
ENDOBRONCHIAL LUNG VOLUMEREDUCTION
Page 131 and 132:
DOES IT WORK?1.41.210.80.60.40.200.
Page 133 and 134:
• Emphysus / PulmonXCLINCAL TRIAL
Page 135 and 136:
INFLAMMATORY CASCADE-switchB lympho
Page 137 and 138:
BRONCHIAL THERMOPLASTY• Bronchial
Page 139 and 140:
BRONCHIAL THERMOPLASTY• Methachol
Page 141 and 142:
AIR2 TrialObjective- To demonstrate
Page 143:
CURRENT STATUS OF BRONCHIALTHERMOPL
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