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Tracheobronchial stents

B Sztanó, G Kiss, K Márai, G Rácz, I Szegesdi, K Rácz, G Katona, L Rovó
OBJECTIVE: The solution of severe tracheobronchial obstructions in early childhood means a great challenge. Biodegradable stents were intended to be a minimally invasive temporary solution which may decrease the number of interventions and limit the possible complications of stenting procedures. However, our first experiences have brought out a new, - especially in childhood - potentially life-threatening complication of this concept. METHODS: Five SX-ELLA biodegradable polydioxanone stents was applied in three patients because of severe tracheobronchial obstruction: congenital tracheomalacia (7 day-old), acquired tracheomalacia (10 month-old), and congenital trachea-bronchomalacia (10 month-old)...
December 2016: International Journal of Pediatric Otorhinolaryngology
Janusz Włodarczyk, Jarosław Kużdżał
INTRODUCTION: The close anatomical relationship between the oesophagus and bronchial tree results in formation of an oesophago-respiratory fistula in a subset of patients with advanced oesophageal or lung cancer. In those patients stenting of both the oesophagus and tracheobronchial tree is a valid option of palliative treatment. AIM: To determine the effectiveness, tolerance, quality of life, safety and survival after double stenting procedures. MATERIAL AND METHODS: Retrospective analysis of a prospectively collected database was performed, concerning consecutive patients with oesophago-respiratory fistulas treated with double stenting...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Alfonso Fiorelli, Umberto Caterino, Antonio Raucci, Mario Santini
Tracheobronchial malignant stenosis is a life-threatening and challenging condition. In inoperable patients, a stent is the mainstay treatment to ensure ventilation. Here, we report the use of a fully covered standard conical self-expandable metallic stent as an emergency treatment for complex tracheobronchial malignant stenosis.
November 3, 2016: Interactive Cardiovascular and Thoracic Surgery
Caroline Dahlqvist, Sebahat Ocak, Maximilien Gourdin, Anne Sophie Dincq, Laurie Putz, Jean-Paul d'Odémont
Introduction. We herein report our experience with new fully covered self-expanding metallic stents in the setting of inoperable recurrent benign tracheobronchial stenosis. Methods. Between May 2010 and July 2014, 21 Micro-Tech® FC-SEMS (Nanjing Co., Republic of Korea) were placed in our hospital in 16 patients for inoperable, recurrent (after dilatation), and symptomatic benign airway stenosis. Their medical files were retrospectively reviewed in December 2014, with focus on stent's tolerance and durability data...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Paola Serio, Raffaella Nenna, Valentina Fainardi, Laura Grisotto, Annibale Biggeri, Roberto Leone, Luigi Arcieri, Marco Di Maurizio, Denise Colosimo, Roberto Baggi, Bruno Murzi, Lorenzo Mirabile, Fabio Midulla
OBJECTIVES: Surgery for vascular anomalies can occasionally fail to relieve symptoms, especially when severe tracheobronchial malacia persists. We studied outcomes in children who underwent airway stenting for severe post-surgical airway malacia and tested known clinical and surgical prognostic factors. METHODS: Among 257 children evaluated for tracheobronchial vascular compression, we reviewed the clinical charts for the 59 patients (23%) who underwent surgery...
October 15, 2016: European Journal of Cardio-thoracic Surgery
Tingting Li, Yonggao Zhang, Yadong Wang, Jianbo Gao, Yan Jiang
The aim of the study was to investigate the image quality of low-dose CT images with different reconstruction algorithms including filtered back projection (FBP), hybrid iterative reconstruction (HIR), and iterative model reconstruction (IMR) algorithms by comparison of routine dose images with FBP reconstruction, in patients with malignant obstructive tracheobronchial diseases.In total, 60 patients (59 ± 9.3 years, 37 males) with airway stent who are randomly assigned into 2 groups (routine-dose [RD] and low-dose [LD] group, 30 for each) underwent chest CT on a 256-slice CT (RD-group 120 kV, 250 mAs, LD-group 120 kV, 120 mAs)...
September 2016: Medicine (Baltimore)
Nitish Fokeerah, Xinwei Liu, Yonggang Hao, Lihua Peng
Managing a patient scheduled for bronchoesophageal fistula repair is challenging for the anesthetist. If appropriate ventilation strategy is not employed, serious complications such as hypoxemia, gastric distension, and pulmonary aspiration can occur. We present the case of a 62-year-old man with a bronchoesophageal fistula in the left main stem bronchus requiring the insertion of a Y-shaped tracheobronchial stent through a rigid bronchoscope, under general anesthesia. We successfully managed this intervention and herein report this case to demonstrate the effectiveness of underwater seal gastrostomy tube drainage used in conjunction with high-frequency jet ventilation during bronchoesophageal fistula stenting...
2016: Case Reports in Anesthesiology
Tomasz Gil, Janusz Warmus, Janusz Włodarczyk, Zbigniew Grochowski, Krzysztof Bederski, Piotr Kocoń, Piotr Talar, Jarosław Kużdżał
INTRODUCTION: Iatrogenic tracheobronchial injuries are rare. AIM: To analyse the mechanism of injury, symptoms and treatment of these patients. MATERIAL AND METHODS: Retrospective analysis of hospital records of all patients treated for main airway injuries between 1990 and 2012 was performed. RESULTS: There were 24 patients, including 21 women and 3 men. Mean time between injury and initiation of treatment was 12 hours (range: 2-48)...
June 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Jad Kebbe, Abdul H Alraiyes, Samjot S Dhillon, Kassem Harris
No abstract text is available yet for this article.
July 2016: Journal of Bronchology & Interventional Pulmonology
Christoph Kampmann, Christiane M Wiethoff, Ralf G Huth, Gundula Staatz, Eugen Mengel, Michael Beck, Stefan Gehring, Torsten Mewes, Tariq Abu-Tair
Several different lysosomal storage diseases, mainly mucopolysaccharidosis (MPS) type I, II, and VI, are complicated by severe obstruction of the upper airways, tracheobronchial malacia, and/or stenosis of the lower airways. Although enzyme replacement therapies (ERTs) are available, the impact of these on tracheobronchial alterations has not been reported. By extending the life expectancy of MPS patients with ERTs, airway problems may become more prevalent at advanced ages. These airway abnormalities can result in severe, potentially fatal, difficulties during anesthetic procedures...
July 22, 2016: JIMD Reports
M J Kim, J H Shin, J-H Park, J H Kim, H-Y Song, J Park, Y C Cho, S H Kim
AIM: To evaluate the technical feasibility and safety of covered airway stent placement for malignant tracheobronchial strictures in patients with an endotracheal tube. MATERIALS AND METHODS: Data regarding retrievable, expandable, metal stent placement under fluoroscopic guidance in 20 patients with an endotracheal tube inserted for malignant tracheobronchial strictures were retrospectively analysed. The clinical effectiveness was assessed using the following variables: technical and clinical success; procedure and stent-related complications; and duration of intubation following stent placement...
November 2016: Clinical Radiology
Teruomi Miyazawa, Seiichi Nobuyama, Hiroki Nishine, Hiroshi Handa, Masamichi Mineshita
BACKGROUND: The point in the airway that allows the smallest maximal flow is known as the "choke point". The tube law describes the velocity of the expired air, which cannot exceed the wave-speed. Flow limitation during forced expiration is affected by the relationship between the transmural pressure (Ptm) and cross-sectional area (A) of the airway. Wave speed is dependent on the stiffness of the airway wall, as well as on the cross-section of the airway itself (dA/dPtm). METHODS: Airway stenting at the wave-speed, flow-limiting segment (choke point) is assessed by using a catheter, via the working channel of a stereoscopic bronchoscope, to measure the difference between lateral pressure and pleural pressure...
July 2016: Respiratory Investigation
Jung-Hoon Park, Pyeong Hwa Kim, Ji Hoon Shin, Jiaywei Tsauo, Min Tae Kim, Young Chul Cho, Jin Hyoung Kim, Ho-Young Song
PURPOSE: The purpose of the study was to retrospectively evaluate the technical outcomes of removal of retrievable self-expandable metallic stents (REMSs) and identify predictors of technical failure in 81 patients with benign and malignant tracheobronchial strictures. MATERIALS AND METHODS: A total of 98 REMSs were removed under fluoroscopic guidance in 81 patients with benign (n = 48) or malignant (n = 33) tracheobronchial strictures. Primary and secondary technical success rates and complication rate were evaluated...
July 14, 2016: Cardiovascular and Interventional Radiology
Melissa McLenon, Gregory J Bittle, Kevin Jones, Jay Menaker, Si M Pham, Aldo T Iacono, Ashutosh Sachdeva, Keshava Rajagopal
Venovenous (V-V) extracorporeal membrane oxygenation (ECMO) is used for respiratory failure that is suspected to be reversible (bridge to recovery), or as a bridge to lung transplantation. Patients with proximal airway obstruction due to endobronchial malignancy can develop acute respiratory failure, and may benefit from V-V ECMO as a bridge to airway intervention, further treatment, and eventual recovery. We describe a case of a superior sulcus tumor with tracheobronchial and superior vena cava invasion causing both respiratory failure and superior vena cava syndrome...
July 2016: Annals of Thoracic Surgery
Juan L Antón-Pacheco
Tracheobronchial obstruction is infrequent in children and still remains a challenging matter of concern. Management alternatives vary from conservative treatment to complex surgical techniques or endoscopic interventional procedures. Airway stenting in children is relatively recent and follows the trail of the experience in adult patients. Nevertheless, there are basic differences between both age groups like the benign nature of most obstructions and the small size of the pediatric airway. These specific features raise the issues of the precise role of tracheobronchial stenting in children and the selection of the most adequate device...
June 2016: Seminars in Pediatric Surgery
Barney Thomas Jesudason Isaac, Ashima Datey, Devasahayam Jesudas Christopher
The use of metallic stents is traditionally not recommended for benign tracheobronchial conditions. With advances in the field of interventional bronchoscopy, metal tracheobronchial stents have occasionally been used to treat benign disease. However, the removal of these stents from the airway is technically difficult. We are reporting the case of a young female subject who received a self-expanding metallic stent for alleviation of post-tubercular bronchostenosis, which was successfully removed after two months without complications...
January 2016: Indian Journal of Tuberculosis
Basil S Nasir, Mehdi Tahiri, Jordan Kazakov, Vicky Thiffault, Pasquale Ferraro, Moishe Liberman
BACKGROUND: Neoplastic involvement of the mediastinum can contribute to both airway and esophageal pathology. That can manifest as combined esophageal and airway stenosis, or tracheobronchoesophageal fistula. Conventional palliative treatment of these problems consists of endoluminal stent insertion. The double stenting approach consists of insertion of a tracheobronchial and an esophageal stent in parallel and allows concomitant symptomatic relief of both the airway and esophageal pathology...
August 2016: Annals of Thoracic Surgery
Ji Ma, Xinwei Han, Gang Wu, Dechao Jiao, Kewei Ren, Yonghua Bi
PURPOSE: To evaluate the intermediate outcomes of temporary partially covered tracheobronchial stenting in patients with benign tracheobronchial stenosis. MATERIALS AND METHODS: We conducted a retrospective study of patients with benign tracheobronchial stenosis who underwent stent placement. All stents were removed approximately 3 months after placement. Respiratory function was assessed using the visual analogue scale (VAS) and Karnofsky performance status scale (KPS) before and after stent placement...
August 2016: Cardiovascular and Interventional Radiology
D J McGrath, B O'Brien, M Bruzzi, N Kelly, J Clauser, U Steinseifer, P E McHugh
Covered tracheobronchial stents are used to prevent tumour growth from reoccluding the airways. In the present work a combination of experimental and computational methods are used to present the mechanical effects that adhered covers can have on stent performance. A prototype tracheobronchial stent is characterised in bare and covered configurations using radial force, flat plate and a novel non-uniform radial force test, while computational modelling is performed in parallel to extensively inform the physical testing...
August 2016: Journal of the Mechanical Behavior of Biomedical Materials
Serena Conforti, Sava Durkovic, Alessandro Rinaldo, Maria Pia Gagliardone, Emanuela Montorsi, Massimo Torre
Palliation of malignant tracheobronchial stenosis is challenging. Published experience with self-expanding Y-shaped stents is limited and it seems necessary to evaluate whether they improve clinical results with respect to alternative prostheses. We present a retrospective case series of 20 consecutive patients with malignant tracheobronchial stenosis that underwent placement of a single-unit, Y-shaped covered metallic stent. Outcomes were: safety of the procedure, palliation of dyspnea, complications, and survival...
April 25, 2016: Archivos de Bronconeumología
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