Jing Zhu,1,2 Xiaoxiao Xu,1,2 Rujuan Wang,1,2 Zhenhua Li,1,2 Ying Wang,1,2 Yi Hu1 

1Department of Pulmonary and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Wuhan Clinical Research Center for Interventional Diagnosis and Treatment of Respiratory Diseases, Hubei, People’s Republic of China

Correspondence: Yi Hu, Department of Pulmonary and Critical Care Medicine, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, 26 Shengli Street, Wuhan, 430014, People’s Republic of China, Tel +86-13995618974, Email huyi@zxhospital.com

Abstract: Pulmonary bullae are a common complication of chronic obstructive pulmonary disease (COPD), but treatment options are limited for patients with poor lung function and giant emphysematous bullae (GEB). We reported a case of a 61-year-old female with severe COPD complicated by a newly developed GEB. Using electromagnetic navigation technology, we precisely located and targeted the bronchi adjacent to the bullae within the lung. Guided by O-arm CT imaging, we punctured the bullae with a biopsy needle, evacuated the air, and administered autologous blood and thrombin. A follow-up pulmonary CT scan three days post-procedure revealed a significant reduction in the size of the giant bulla. Additionally, the patient’s wheezing symptoms improved, and her performance on the 6-minute walk test showed some enhancement.

Keywords: pulmonary bulla, chronic obstructive pulmonary disease, bronchoscope, bronchoscopic lung volume reduction