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Trachea stent

Brooks V Udelsman, Jessica Eaton, Ashok Muniappan, Christopher R Morse, Cameron D Wright, Douglas J Mathisen
OBJECTIVE: Patients with complicated airway defects that exceed the limits of primary repair represent a challenging clinical problem and require alternative techniques for repair. The aim of this study was to evaluate bioprosthetic reconstruction of large tracheal and bronchial defects. METHODS: Retrospective chart review of patients treated at a single tertiary center from 2008 to 2015 who underwent repair of tracheal or bronchial defects with a bioprosthetic device, namely aortic homograft or acellular dermal matrix...
November 2016: Journal of Thoracic and Cardiovascular Surgery
Insu Kawahara, Shigeru Ono, Kosaku Maeda
PURPOSE: Congenital tracheal stenosis (CTS) is a rare condition and difficult to treat. Slide tracheoplasty has unsatisfactory outcomes for severe neonatal symptomatic CTS. This study evaluated the use of biodegradable polydioxanone stents (BD stent) in a rabbit model of CTS. METHODS: Tracheal stenosis was induced in female Japanese white rabbits, 9-10weeks old, by direct scraping of the tracheal mucosa with a nylon brush following transverse incision of the trachea (control group, n=4)...
September 15, 2016: Journal of Pediatric Surgery
Konrad Hoetzenecker, Thomas Schweiger, Imme Roesner, Matthias Leonhard, Gabriel Marta, Doris M Denk-Linnert, Berit Schneider-Stickler, Wolfgang Bigenzahn, Walter Klepetko
OBJECTIVES: Repair of laryngotracheal stenosis with pronounced side-to-side narrowing and involvement of the glottis is challenging and usually requires laryngotracheal reconstruction with rib cartilage interpositions. This technique, as first described by Couraud, needs prolonged postoperative stabilization with Montgomery T-tubes, imposing significant morbidity and discomfort on patients. We describe our initial experience with a modified laryngotracheal reconstruction technique that avoids the need for prolonged postoperative stenting...
October 2016: Journal of Thoracic and Cardiovascular Surgery
M Ulusoy, I I Uysal, A S Kıvrak, S Ozbek, A K Karabulut, Y Paksoy, N U Dogan
OBJECTIVE: The aims of this study are the identification of differences in the diameter, length, area and branching angles of the trachea and bronchi with gender and age, and the identification of trachea types by using MDCT images. PATIENTS AND METHODS: The thoracic MDCT images of 253 patients (0-74 years old, 142 male and 111 female) were evaluated. Tracheal diameter, tracheal cross-sectional area, diameter and length of bronchi, and several angles of the bronchial tree [e...
August 2016: European Review for Medical and Pharmacological Sciences
H Hoffmann, D Gompelmann, C P Heußel, H Dienemann, R Eberhardt
Patients with diffuse airway instability due to tracheobronchomalacia or excessive dynamic airway collapse are typically highly symptomatic, with marked dyspnoea, recurrent bronchopulmonary infections and excruciating intractable cough. Silicone stents achieve immediate symptom control, but are - due to the typical complications associated with stent treatment - usually not an option for long-term treatment. The aim of surgical intervention is definitive stabilisation of the trachea and of both main bronchi by posterior splinting of the Paries membranaceus with a polypropylene mesh...
September 2016: Zentralblatt Für Chirurgie
Amir C Dayan, Richard H Epstein
BACKGROUND: An intact pilot balloon assembly is crucial to the proper function of a cuffed tracheal tube. Disruption of the pilot balloon, transection of the inflation line, or valve incompetence results in cuff deflation, which may lead to inadequate ventilation and aspiration of secretions. Such failures typically result in tracheal tube replacement, but this may be a safety risk if a difficult reintubation is anticipated. We recently encountered such a patient who remained intubated postoperatively and in whom the inflation line was transected, causing a large leak...
September 7, 2016: Anesthesia and Analgesia
B L Powell
A 48-year-old woman was seen in a surgical outpatient clinic with a 2 year history of progressive dysphagia with occasional regurgitation, partially controlled with a proton pump inhibitor. Primary investigations of pH testing and gastroscopy were normal, although a barium swallow study revealed significant hold-up at the aortic arch impression and a posterior right-sided oesophageal impression suggestive of a right-sided aortic arch. A follow-up computed tomography angiogram discovered a vascular ring encircling the trachea and oesophagus, formed by a right-sided aortic arch with aberrant aortic branches, and a Kommerell's diverticulum...
August 23, 2016: Annals of the Royal College of Surgeons of England
Liping Zhao, Sumati Sundaram, Andrew V Le, Angela H Huang, Jiasheng Zhang, Go Hatachi, Arkadi Beloiartsev, Michael G Caty, Tai Yi, Katherine Leiby, Ashley Gard, Mehmet H Kural, Liqiong Gui, Kevin A Rocco, Amogh Sivarapatna, Elizabeth Calle, Allison Greaney, Luca Urbani, Panagiotis Maghsoudlou, Alan Burns, Paolo DeCoppi, Laura E Niklason
Here we report the creation of a novel tracheal construct in the form of an engineered, acellular tissue-stent biocomposite trachea (TSBT). Allogeneic or xenogeneic smooth muscle cells are cultured on polyglycolic acid polymer-metal stent scaffold leading to the formation of a tissue comprising cells, their deposited collagenous matrix, and the stent material. Thorough decellularization then produces a final acellular tubular construct. Engineered TSBTs were tested as end-to-end tracheal replacements in 11 rats and 3 nonhuman primates...
September 2016: Tissue Engineering. Part A
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
Levent Dalar, Seda Tural Önür, Cengiz Özdemir, Sinem Nedime Sökücü, Ahmet Levent Karasulu, Sedat Altin
BACKGROUND/AIM: Tracheobronchomalacia (TBM) leads to the obstruction of expiratory airflow and interference with secretion clearance. Stabilization of the airway wall using a silicon stent or laser coagulation of the posterior wall may be treatment options. This study aimed to retrospectively analyze which interventional bronchoscopic method could be used to provide airway stabilization and gain control of symptoms and for whom this method could be used. MATERIALS AND METHODS: Fifteen patients who had received treatment in our interventional pulmonology unit were analyzed...
2016: Turkish Journal of Medical Sciences
Dakshesh R Shah, Varsha Mungutwar
This is a case of failed attempt of hanging, resulted into cervical injury & injury to the trachea. Patient was put on the ventilator for respiratory support for long period. Poor recovery of the patient resulted into prolong tracheostomy tube. Combine effect of all resulted into suprastomal tracheal stenosis. Due to complexity of the problem a novel method was customized to correct the tracheal stenosis. Strap muscle (Sternohyoid & Sternothyroid) was raised as a flap; free cartilage was sandwiched in between and sutured to the created tracheal defect...
September 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
Rachid Tazi-Mezalek, Ali I Musani, Sophie Laroumagne, Philippe J Astoul, Xavier B D'Journo, Pascal A Thomas, Hervé Dutau
BACKGROUND AND OBJECTIVE: Iatrogenic tracheal injury (ITI) is a rare yet severe complication of endotracheal tube (ETT) placement or tracheostomy. ITI is suspected in patients with clinical and/or radiographic signs or inefficient mechanical ventilation (MV) following these procedures. Bronchoscopy is used to establish a definitive diagnosis. METHODS: We conducted a retrospective, single-centre chart review of 35 patients between 2004 and 2014. Depending on the nature and location of ITI and need for MV, patients were triaged to surgical repair, endoscopic management with airway stents or conservative treatment consisting of ETT or tracheotomy cannula (TC) placement distal to the wound and bronchoscopic surveillance...
November 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Yu Liu, Tao Lu, Yongxing Zhang, Yulei Qiao, Junjie Xi, Qun Wang
OBJECTIVES: Artificial tracheas fabricated from collagen-conjugated mesh appear to overcome fatal postoperative complications, namely anastomotic dehiscence and prosthesis dislocation. Such prostheses are incorporated by host tissue, provided they are wrapped in omentum (necessitating an additional abdominal procedure) and a silicone tube is used as a stent (to be extracted several weeks postoperatively). To mitigate related host impact (i.e. injury, pain and distress), we investigated the feasibility of implanting this type of tracheal prosthesis (∼5 cm in length) alone, without omental wrapping and use of a silicone stent...
July 17, 2016: Interactive Cardiovascular and Thoracic Surgery
Aleksander Góra, Damian Pliszka, Shayanti Mukherjee, Seeram Ramakrishna
Tissue engineering of tubular organs such as the blood vessel, trachea gastrointestinal tract, urinary tract are of the great interest due to the high amount of surgeries performed annually on those organs. Development in tissue engineering in recent years and promising results, showed need to investigate more complex constructs that need to be designed in special manner. Stent technology remain the most widely used procedure to restore functions of tubular tissues after cancer treatment, or after organ removal due to traumatic accidents...
January 2016: Journal of Nanoscience and Nanotechnology
Benjamin E Lee, Robert J Korst
We report the case of a 63-year-old woman who required emergent intubation after a choking episode at home. It resulted in a 5-cm tear in the membranous trachea. She was treated by placement of a temporary tracheal stent, which was successfully removed 3 months later.
July 2016: Annals of Thoracic Surgery
Farzad Izadi, Reza Vaghardoost, Vita Derakhshandeh, Behnam Sobouti, Yaser Ghavami
INTRODUCTION: Laryngotracheal stenosis can be caused after traumatic injuries to the neck from the subglottic larynx to the trachea. Patients with laryngotracheal stenosis often need a tracheotomy and occasionally may become tracheotomy dependent. Different procedures have been described for the management of these lesions. Management options include techniques of endoscopic dilation, laser resection, laryngo-fissure, and an innovative array of plastic reconstructions with or without the use of stents...
March 2016: Iranian Journal of Otorhinolaryngology
Changwan Ryu, Jonathan Puchalski, Michael Perkins, Shyoko Honiden
Vascular rings are congenital malformations of the aortic arch. A double aortic arch (DAA), the most common type of vascular ring, results from the failure of the fourth embryonic branchial arch to regress, leading to an ascending aorta that divides into a left and right arch that fuse together to completely encircle the trachea and esophagus. The subsequent DAA causes compressive effects on the trachea and esophagus that typically manifests in infancy or early childhood. Adult presentations, particularly in the elderly, are exceedingly rare...
2016: Respiratory Medicine Case Reports
Teng-Fei Li, Xu-Hua Duan, Xin-Wei Han, Gang Wu, Jian-Zhuang Ren, Ke-Wei Ren, Hui-Bin Lu
OBJECTIVE: To determine the safety and feasibility of combined-type integrated Y-shaped self-expanding covered metallic stents to treat gastrotracheal fistulas (GTFs) and gastrobronchial fistulas (GBFs). METHODS: We retrospectively reviewed the data of 10 patients with postoperative GTFs or GBFs. Depending on the size and location of the fistula and the airway diameter, we custom-designed 2 or 3 stents for each patient. The combined-type stents consisted of a large and a small Y-shaped stent...
August 2016: Journal of Thoracic and Cardiovascular Surgery
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
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