A Case of Airway Hemorrhage Performed Emergency Hemostasis Using Endobronchial Watanabe Spigot (EWS^®)

Abstract

We have achieved emergency hemostasis for the recurrent bouts of hemoptysis by bronchial occlusion using Endobronchial Watanabe Spigot (EWS), followed by embolization of the bronchial artery responsible for the hemorrhage, in that the EWSs could be removed at the third month after the bronchial occlusion. The patient was a woman in her thirties. She had undergone left lobectomy and left cervical lymph node dissection for medullary carcinoma of the thyroid in her twenties, and resultantly she had had bilateral recurrent laryngeal neuroparalysis. She experienced recurrence to the right lobe of the thyroid in her thirties and a permanent tracheostoma was created for dyspnea. Three months later, she was brought into our hospital by ambulance because of hemoptysis. After admission, she had recurrent bouts of hemoptysis and she was referred to our department for the purpose of close examinations and treatment of recurrent hemoptysis. Bronchoscopy under general anesthesia revealed arterial bleeding from the inlet portion of the right B3. Thrombin solution was infused under bronchoscopy and EWSs were placed to achieve hemostasis. In addition the bronchial artery to the right upper lobe of the lung was embolized. Thereafter no hemoptysis had occurred and the EWSs were removed three months after the placement. No hemoptysis has occurred, as of one month after the removal.