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EWS®

Silicone Spigots for Segmental and Subsegmental Bronchi

Endobronchial Watanabe Spigots (EWS®) were developed by NOVATECH in close cooperation with Dr. Y. Watanabe, Okayama, Japan. They are made of medical grade silicone (implantable for more than 29 days) dyed with barium-sulfate for excellent radiodiagnostic visibility. EWS® are tapered and have an anatomical design with studs on the outside avoiding migration. They come sterile, individually blister-packed.

Indications

  • persistent (even after successful pleural drainage), inoperable pneumothorax,
  • bronchopleural fistula (especially following thoracic surgery) with a continuous loss of air despite thoracic suction drain, in cases in which surgical intervention is not indicated,
  • temporary treatment of haemoptysis of peripheral origin in expectation of a bronchial arterial embolisation or surgery1).

A study performed in Japan with 63 patients including 40 cases of intractable pneumothorax, 12 cases of pyothorax with fistula and 7 cases of pulmonary fistula has shown that using EWS® is safer and has more permanent positive results than conventional methods. After determination of the affected bronchi with a balloon catheter (alternatively X-ray etc.), the EWS® are placed with a flexible bronchoscope and forceps guided by the working channel of the bronchoscope. EWS® were successfully placed in 96.7 % of the cases. The loss of air was stopped or significantly reduced in 77.6 % of the cases. No severe complications ocurred 2).

Subsequent therapy

  • For certain patients bronchial occlusion with EWS® can be envisaged as the only treatment. When it fails or the result is imperfect, pleurodesis (for example using STERITALC®) or other surgery (if not contra-indicated) can be considered.
  • The spigots can be removed after the patient’s condition has improved and the thoracic drain is removed. If there are difficulties in removing EWS® for any reason, removal is not necessary.

1)H. Dutau et al. Endobronchial Embolization with a Silicone Spigot as a Temporary Treatment for Massive Hemoptysis. Respiration DOI:101159/000092954, published online April 21, 2006
2) Watanabe Y. et al. Bronchial Occlusion with Endobronchial Watanabe Spigot, J Bronchol., 10, 4, 2003

Ordering Information

Three sizes available:

S = Ø 5 mm
M = Ø 6 mm
L = Ø 7 mm

REF

 

 

01EWS12A

12 EWS®

3 x S, 6 x M, 3 x L

01EWS3S

6 EWS®

6 x S, Ø 5 mm

01EWS3M

6 EWS®

6 x M, Ø 6 mm

01EWS3L

6 EWS®

6 x L, Ø 7 mm