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<p>Introduction: Airway obstruction due to retained intrabronchial blood clots is a potentially life-threatening emergency that may lead to lobar or whole-lung collapse and severe hypoxemia. Conventional bronchoscopic methods such as suction, forceps extraction, or balloon catheter dislodgement are frequently inadequate for large and adherent clots. Bronchoscopic cryoextraction, based on cryoadhesion, enables en bloc clot removal and has emerged as a valuable therapeutic tool in such scenarios. Case Description: We report a series of five patients with life-threatening airway obstruction due to blood clots managed successfully with flexible bronchoscopic cryoextraction. Clinical contexts included coagulopathy in a patient with hematological malignancy, airway compromise after cryodebulking of a malignant endobronchial lesion, post-EBUS bleeding, tuberculosis-related hemoptysis, and an endobronchial carcinoid tumor presenting with massive clot retention. In all cases, cryoextraction of retained clots was done using 1.7-mm and 2.4-mm cryoprobes with rapid restoration of airway patency. Post-procedure, patients demonstrated improved oxygenation, radiological resolution, and were successfully weaned from mechanical ventilation. Conclusions: Bronchoscopic cryoextraction is a safe, rapid, and effective technique for management of airway obstruction due to retained blood clots across diverse clinical settings.</p>

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Bronchoscopic Cryoextraction in Life Threatening Airway Obstruction from Blood Clots- a Case Series of Five Patients

  • 期刊论文

  • 发表日期：

    2025年11月29日

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  • Neeraj Sharma,
  • Kunal Kumar,
  • Robin Choudhary,
  • Amit Singh Vasan,
  • Shibu Sasidharan,
  • Dilesh PK

摘要

Introduction: Airway obstruction due to retained intrabronchial blood clots is a potentially life-threatening emergency that may lead to lobar or whole-lung collapse and severe hypoxemia. Conventional bronchoscopic methods such as suction, forceps extraction, or balloon catheter dislodgement are frequently inadequate for large and adherent clots. Bronchoscopic cryoextraction, based on cryoadhesion, enables en bloc clot removal and has emerged as a valuable therapeutic tool in such scenarios. Case Description: We report a series of five patients with life-threatening airway obstruction due to blood clots managed successfully with flexible bronchoscopic cryoextraction. Clinical contexts included coagulopathy in a patient with hematological malignancy, airway compromise after cryodebulking of a malignant endobronchial lesion, post-EBUS bleeding, tuberculosis-related hemoptysis, and an endobronchial carcinoid tumor presenting with massive clot retention. In all cases, cryoextraction of retained clots was done using 1.7-mm and 2.4-mm cryoprobes with rapid restoration of airway patency. Post-procedure, patients demonstrated improved oxygenation, radiological resolution, and were successfully weaned from mechanical ventilation. Conclusions: Bronchoscopic cryoextraction is a safe, rapid, and effective technique for management of airway obstruction due to retained blood clots across diverse clinical settings.