Pleurodesis with Iodized Talc for Malignant Effusions Using Pigtail Catheters

OBJECTIVE:

To assess the efficacy of using an iodized talc slurry as a sclerosing agent instilled into the pleural space via a 12-French pigtail catheter for controlling malignant pleural effusions.

DESIGN:

A prospective study in which patients were followed until their death.

SETTING:

A university-affiliated tertiary-care teaching hospital.

PATIENTS:

Medical oncology patients admitted with symptomatic malignant pleural effusions were considered for iodized talc pleurodesis.

MAIN OUTCOME MEASURES:

The control of pleural effusion. Treatment failure was defined as any reaccumulation of fluid in the pleural space.

RESULTS:

Fifteen patients were treated for a total of 17 instillations. The median follow-up on all patients until death was 6 months (range 1–20). The most frequent adverse effect in the study group was pleuritic chest pain (60%). The probability of control of effusion, as determined by the method of Kaplan–Meier, was 81% (SEM 9.7%). The cost of preparing 5 g of iodized talc was $4.32 (US).

CONCLUSIONS:

Iodized talc slurry instilled through a small-bore pigtail catheter is a safe, economical, and effective treatment for malignant pleural effusion.