Assistant Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine); Director, Interventional Pulmonology, Pulmonary, Critical Care & Sleep Medicine
Yale Interventional Pulmonary Program
Yale Interventional Pulmonary offers the most advanced diagnostic and therapeutic approaches to various diseases in the chest, including lung nodules and masses, enlarged lymph nodes (mediastinal adenopathy), complex airways and pleural effusions. Our trained interventional pulmonologists are leaders in the field and have more experience than anybody in the state and surrounding area. Our goal is to provide an expedited, comprehensive assessment and state-of-the-art treatment with the following services:
Diagnostic bronchoscopy
- Robotic bronchoscopy: Yale IP was the first in the state to utilize the new shape-sensing robotic bronchoscopy. Robotic bronchoscopy is an accurate, safe, and efficient method biopsies of peripheral lung abnormalities. When done in our state-of-the-art procedural rooms, robotic bronchoscopy combined with simultaneous cone-beam CT scanning and endobronchial ultrasound allow us to reach previously inaccessible parts of the lung, for even greater precision in the diagnosis and staging of potential lung cancer.
- Endobronchial ultrasound (EBUS): The Yale IP physicians have the most experience in the state with EBUS. Whether using convex probe EBUS for mediastinal lymph node enlargement, often circumventing the need for more invasive procedures like mediastinoscopy, or peripheral EBUS for lung nodules, our program provides the greatest diagnostic accuracy possible with the bronchoscope.
Therapeutic bronchoscopic interventions
- Airway stenting: The Yale IP physicians perform flexible and rigid bronchoscopy to place any type of stent available for complex airway disease. This includes obstruction due to cancer as well as the unique “Y-stents” for tracheobronchomalacia.
- Ablative therapy: Argon plasma coagulation (APC), electrocautery or cryotherapy can be used to treat malignant tumors or benign growths in the main airways of the lungs.
- Bronchoplasty: Our physicians use balloons similar to those used in angioplasty for heart disease to make airways bigger so that breathing is easier. This is often used for tumors, scarring after radiation treatment, or other conditions.
- Endobronchial valves: Yale bronchoscopic lung volume reduction program (BLVR) was designed to care for patients with severe emphysema who continue to experience shortness of breath and limitations with activities of daily living despite optimal medical management. The multidisciplinary program was established by Yale Medicine’s distinguished interventional pulmonologists, COPD experts, thoracic surgeons, physician assistants, nurses, and support staff to provide latest, evidence-based, individualized care and an opportunity to participate in clinical trials.
Advanced pleural procedures
- Thoracentesis: We provide ultrasound-guided thoracentesis and determine the next steps needed for patients with pleural effusions. We provide unique, ongoing care to help prevent this fluid from returning.
- Medical thoracoscopy (pleuroscopy): Biopsies of the pleura are sometimes needed to help determine the cause of recurrent pleural effusions. We perform this procedure typically as an outpatient and often with concurrent pleurodesis and/or tunneled pleural catheter placement.
- Tunneled pleural catheter placement: We can place a pleurx® or similar catheter so that a patient does not need to have repeated thoracentesis if the pleural effusion recurs.
In collaboration with thoracic surgery as well as the physicians of the Thoracic Oncology Program (TOP), the Yale IP team provides unmatched services in bronchoscopic and pleural procedures. Furthermore, we continue to perform research to ensure the most advanced care possible.
- Yale IP Team
- Robotic Bronchoscopy
- Endobronchial Valves
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- Dr. Bramley completed his undergraduate education at SUNY Binghamton with a degree in Biochemistry. He then received his medical school training at SUNY Downstate Medical Center in Brooklyn, NY. After graduation, he completed a residency in Internal Medicine at Yale - New Haven Hospital. During this time he completed research in the Section of Pulmonary, Critical Care and Sleep Medicine examining the daily variation of sedative medication dosing in the Medical Intensive Care Unit. After completing his residency, he was chosen to serve as a Chief Resident in the Department of Internal Medicine. Dr. Bramley then completed fellowship training in Pulmonary and Critical Care Medicine at Yale University and Yale - New Haven Hospital. During his fellowship he completed research with the Thoracic Interventional Program evaluating a novel technique to biopsy lymph nodes in the chest. After completing his Pulmonary and Critical Care Medicine fellowship, he completed an additional fellowship in Interventional Pulmonology at the Hospital of the University of Pennsylvania in Philadelphia. Dr. Bramley joined the Pulmonary, Critical Care and Sleep Medicine faculty in 2015. His clinical interests are in all aspects of Interventional Pulmonology, including pleural disease, benign and malignant airways disease and using advanced technologies to diagnose and treat pulmonary lesions.
Assistant Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine); Director of Pulmonary Procedural Education, Pulmonary, Critical Care & Sleep Medicine
Assistant Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine)
Interests: minimally invasive airway and pleural procedures, robotic bronchoscopy, lung cancer diagnosis and management, lung cancer ablation, pleural disease, simulation, biomedical innovationStaff Affiliate - YNHH
Dana Teodoro is a board-certified Physician Assistant. She received her Master of Science in Physician Assistant studies at Mercy College. She began her career working in the Medical Intensive Care Unit at Yale New Haven Hospital and then transitioned to a position at NYU helping to build an Interventional Pulmonary Service. She later returned to Yale to join the Interventional Pulmonary Service where she specializes in the care and management of patients with a variety of pleural and advanced lung pathologies including pleural effusions, pneumothoraxes, malignant and benign airway obstruction, tracheal stenosis, and chronic respiratory failure.Staff Affiliate - YNHH
Cindy Boutilier is a board-certified Acute Care Adult Nurse Practitioner (ANCC). She received her Master's of science in nursing from the University of Connecticut with a focus in critical care medicine. She began her career working in the Medical Intensive Care Unit until transitioning to outpatient Pulmonary Office. She followed her love for inpatient medicine back to the hospital where she currently works on the Interventional Pulmonary Service. She sees and manages a variety of pleural and advanced lung pathologies including but not limited to pleural effusion (exudative / transudative), pneumothorax, hemothorax, chest tube placement / management, Pleurx catheter placement / management, assists in bronchoscopy for lung masses / airway obstruction, assists with percutaneous tracheostomy placement, and daily tracheostomy care including tracheostomy changes and decannulation.Instructor; Instructor of Medicine, Pulmonary - PCCM - Critical Care
Dr. Morton is a New Jersey native, having done his undergraduate and medical school training there there. He then came to Connecticut to train in internal medicine at Yale - New Haven Hospital. He subsequently stayed on to complete his internal medicine chief year and then fellowships in Pulmonary, Critical Care and Interventional Pulmonology. He joined the faculty where his interests include resident and fellow education, robotic bronchoscopy and bronchoscopic lung volume reduction, among others. He is an amateur woodworker and enjoys spending time in the outdoors.