Normally, the lung is covered in a thin film of tissue, as is the inner lining of the rib cage and chest wall, and these two films are stuck together. However, sometimes air, fluid or both gets between these layers, separating them and limiting the ability of the lung to expand during breathing. When excess fluid develops between these layers, this is called pleural effusion. Pleurodesis is a technique to make these two layers stick together.
How does the procedure work?
The interventional radiologist, using image guidance, will typically place a small tube in the space between the layers. The fluid or air is nearly completely drained. Then a substance will be placed between the layers to cause an inflammation on their surfaces. The newly inflamed surfaces then stick together. This keeps the lung expanded and stuck up against the inner chest wall and helps prevent re-accumulation of fluid or air.
Why perform it?
This procedure aids breathing by helping the lungs maintain their maximum volume. It can be used for cancerous and non-cancerous causes of air and fluid accumulation, such as cancerous fluid, infected fluid and punctured lung. In most cases, simple drainage will be sufficient treatment, but if they recur frequently or rapidly pleurodesis may be recommended.
What are the risks?
The initial placement of the tube through the chest wall can cause bleeding or injury to the lung or surrounding organs. You may experience an infection of the skin or the fluid.
1. Bloom AI, Wilson MW, et al. Talc pleurodesis through small-bore percutaneous tubes. Cardiovasc Intervent Radiol 1999; 22(5): 433-436.
2. Thornton RH, Miller Z, et al. Tunneled pleural catheters for treatment of recurrent malignant pleural effusion following failed pleurodesis. J Vasc Interv Radiol 2010; 21(5): 696-700.