Interventional Pulmonology

We strive to provide multidisciplinary care for patients with benign and malignant central airway obstruction, lung cancer and diseases of the pleura. Our goal is to provide expeditious care in a multidisciplinary fashion with outstanding communication to both the patient and the referring physicians.

In addition to airway obstruction from malignancy, we treat non-malignant central airway obstruction due to diseases such as tracheal or sub-glottic stenosis, tracheobronchomalacia, relapsing polychondritis, relapsing respiratory papillomatosis, Wegener’s granulomatosis, foreign body removal and pulmonary alveolar proteinosis. The complex airway team includes Interventional Pulmonology, Otolaryngology Head and Neck Surgery, Thoracic Surgery and Anesthesiology.

Patients with lung nodules or masses as well as hilar and mediastinal adenopathy are evaluated and treated in a multidisciplinary approach with members of Interventional Pulmonology, Medical Oncology, Thoracic Surgery and Radiation Oncology in the UNC MTOP clinic and multidisciplinary conference.

We are fortunate to be able to provide all modalities for central airway intervention, lung cancer staging/treatment and bronchopleural fistula available, allowing individualized treatment tailored to each patient. These technologies include:

Therapeutic Bronchoscopy

  • Rigid bronchoscopy
  • Thermal ablation techniques including:
    • Argon plasma coagulation
    • Electrocautery
    • Cryotherapy
  • Laser bronchoscopy
  • Photodynamic therapy
  • Endobronchial brachytherapy
  • Silicone, metallic, and hybrid airway stents
  • Montgomery T-tube placement
  • Powered instrumentation (microdebrider)
  • Balloon bronchoplasty
  • Fiducial marker placement for stereotactic radiosurgery (CyberKnife®)
  • Intrabronchial valve (IBV® Spiration valve)

Advanced Diagnostic Bronchoscopy

  • Endobronchial ultrasound (EBUS)
  • Peripheral radial endobronchial unlrasound (radial EBUS)
  • Autofluorescence and narrow-band imaging
  • Electromagnetic navigational bronchoscopy

Pleural Disease

We also provide consultation and treatment of benign and malignant pleural disease such as mesothelioma, metastatic cancer, connective tissue diseases, bronchopleural fistula/persistent air leak and both acute and chronic infection in concert with Medical Oncology, Thoracic Surgery and Interventional Radiology. We perform all pleural procedures under image guidance (ultrasound or CT) including:

  • Thoracentesis
  • Pleural manometry
  • Tunneled pleural catheter (PleurRx®) placement
  • Pigtail catheters
  • Chemical pleurodesis
  • Medical thoracoscopy

Interventional pulmonology is a rapidly growing procedurally focused subspeciality of pulmonary medicine.  We offer a one year, inteventional pulmonology fellowship. To learn more about this fellowship, please visit our website.

Contact information:

Jason A. Akulian, MD MPH
Director, Interventional Pulmonology
Assistant Professor of Medicine
Pulmonary and Critical Care Medicine
Office: (919) 966-2531
Fax: (919) 966-7013

For Interventional Pulmonology consultation and treatment:

Appointments: (984) 974-8641
Fax: (919) 445-6012

For Pleural Disease consultation and treatment:

Appointments: (984) 974-8641
Fax: (919) 445-6012