Platelet-Rich Plasma for Non-Invasive Closure of Tracheal and Bronchial Fistulas: A Case Series
Abstract
Airway fistulas remain life-threatening complications following thoracic surgery or prolonged mechanical ventilation. Conventional treatments are mainly invasive and associated with significant morbidity. Platelet-rich plasma (PRP), an autologous platelet concentrate with regenerative and immunomodulatory properties, has recently been explored as a minimally invasive therapeutic option; however, its use in airway fistulas remains experimental.
We report two high-risk patients: a 58-year-old male who developed a tracheoesophageal fistula (TEF) after prolonged intubation with a size 8.0 mm endotracheal tube for severe pneumonia and septic shock, and a 65-year-old female with a post-lobectomy bronchopleural fistula (BPF) following surgery for bronchiectasis. Both patients were unsuitable for surgical repair due to poor physiological reserve and high perioperative risk. Endoscopic autologous PRP prepared using a double-centrifugation protocol was injected circumferentially around the fistulous openings in two sessions at 2-week intervals.
Complete fistula closure was achieved in both cases, confirmed by bronchoscopy and computed tomography. No procedure-related complications occurred. Clinical recovery was sustained at 3-month follow-up.
Endoscopic PRP injection may represent a feasible minimally invasive alternative for selected high-risk patients with airway fistulas. Its regenerative, pro-angiogenic and immunomodulatory properties provide biological plausibility for its…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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