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Airways stent

Sakura Okamoto, Hideo Saka, Masahide Oki, Namie Somiya, Sachiyo Yokoyama, Yoshihiro Mizutani, Akiko Kada, Akira Tomita
Airway stenting is a procedure in which a stent is inserted into a stenotic site in the airway. However, the optimal ventilation for airway stenting remains controversial. We have planned a randomized, unblinded controlled study to compare intraoperative respiratory status by dividing patients, who underwent airway stenting, into spontaneous respiration (SP) and controlled ventilation with muscle relaxants (MR) groups. This study started in April 2016. The subjects, patients aged ≥20 years with airway stenosis caused by malignant neoplasms for which airway stenting was scheduled, are randomly allocated to SP and MR groups...
March 16, 2018: Kurume Medical Journal
Yoshitaka Shimizu, Takahito Okazaki, Tomoaki Hamana, Masahiro Irifune
Treatment of pseudoaneurysms in the internal carotid artery (ICA) is associated with a high risk of cerebral infarction; therefore, vessel ligation for hemostasis must be avoided. A 66-year-old man had intraoral hemorrhaging. At the time of the initial examination, computed tomography angiography showed jaw plate displacement near the ICA. A more detailed image was obtained using digital-subtraction angiography. After evaluation of the image, a pseudoaneurysm was diagnosed. Six days later, there were concerns about aspiration and airway obstruction; therefore, tracheostomy was performed...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
Bruce F Sabath, David E Ost
PURPOSE OF REVIEW: The current review describes the latest evidence regarding the use of stents for malignant airway obstruction. RECENT FINDINGS: Therapeutic bronchoscopy, including stenting, can restore patency in up to 93% of patients with malignant central airway obstruction. The patients that benefit the most are those with worse baseline dyspnea, higher American Society of Anesthesiology score, poorer functional status, and central obstruction (rather than lobar)...
March 13, 2018: Current Opinion in Pulmonary Medicine
Beomsu Shin, Boksoon Chang, Hojoong Kim, Byeong-Ho Jeong
BACKGROUND: Interventional bronchoscopy is considered an effective treatment option for malignant central airway obstruction (MCAO). However, there are few reports of interventional bronchoscopy in patients with MCAOs due to extra-pulmonary malignancy. Therefore, the objective of this study was to investigate treatment outcomes and prognostic factors for bronchoscopic intervention in patients with MCAO due to extra-pulmonary malignancy. METHODS: We retrospectively analyzed consecutive 98 patients with MCAO due to extra-pulmonary malignancy who underwent interventional bronchoscopy between 2004 and 2014 at Samsung Medical Center (Seoul, Korea)...
March 13, 2018: BMC Pulmonary Medicine
Christopher Mallow, Jeffrey Thiboutot, Roy Semaan, Margaret M Hayes, Russell Hales, Ashwin Ram, David Feller-Kopman, Hans Lee, Lonny Yarmus
BACKGROUND AND OBJECTIVE: Malignant airway obstruction (MAO), a common complication of patients with advanced lung cancer, causes debilitating dyspnoea and poor quality of life. Two common interventions used in the treatment of MAO include bronchoscopy with airway stenting and external beam radiotherapy (EBRT). Data are limited regarding their clinical effectiveness and overall effect on survival. METHODS: A retrospective chart review of patients treated with airway stenting and/or EBRT at the Johns Hopkins Hospital for MAO between July 2010 and January 2017 was reviewed...
March 12, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
Sevak Keshishyan, Arjun Mohan, Saman Ahmed, Samjot Singh Dhillon, Monali Patil, Kassem Harris
Iron Pill Aspiration (IPA) is a challenging medical condition that requires prompt management to prevent detrimental outcomes. One of the most serious complications of IPA is airway inflammation which commonly leads to severe obstruction. Airway complications may require surgical intervention including the resection of the affected lung. Prompt recognition and management of IPA can reduce the risk of airway complications and may prevent the need of a surgical intervention. Bronchoscopic management entails the use of flexible and rigid bronchoscopes along with balloon bronchoplasty, ablation of the inflammatory tissue causing obstruction and airway stenting...
October 8, 2017: Heart, Lung & Circulation
Céline Thomet, Ali Modarressi, Eva Meia Rüegg, Pavel Dulguerov, Brigitte Pittet-Cuénod
Long-segment tracheal reconstruction remains a challenge. The ideal tracheal substitute should be an epithelialized tube to prevent stenosis and sufficiently rigid to maintain airflow patency. An autologous technique using a radial forearm free flap reinforced by rib cartilage has been recently described for tracheal reconstruction. We report here two cases of complex tracheal reconstruction with a modification of this technique, which consists of the creation of two independent skin paddles to allow the reconstruction of the trachea and a second adjacent defect (eg, cervical skin, esophagus)...
February 27, 2018: Annals of Plastic Surgery
Karan Madan, Anant Mohan, Ritesh Agarwal, Vijay Hadda, Gopi C Khilnani, Randeep Guleria
Background: There is a lack of contemporaneous data on the practices of flexible bronchoscopy in India. Aim: The aim of the study was to study the prevalent practices of flexible bronchoscopy across India. Methods: The "Indian Bronchoscopy Survey" was a 98-question, online survey structured into the following sections: general information, patient preparation and monitoring, sedation and topical anesthesia, procedural/technical aspects, and bronchoscope disinfection/staff protection...
March 2018: Lung India: Official Organ of Indian Chest Society
Lenard Tai Win Cheng, Tiong Beng Sim, Win Sen Kuan
BACKGROUND: Critical central airway obstruction (CAO) requires emergent airway intervention, but current guidelines lack specific recommendations for airway management in the emergency department (ED) while awaiting rigid bronchoscopy. There are few reports of the use of noninvasive ventilation (NIV) in tracheomalacia, but its use as a temporizing treatment option in fixed, malignant CAO has not, to the best of our knowledge, been reported. CASE REPORT: An 84-year-old woman presented to the ED in respiratory distress, too breathless to speak and using her accessory muscles of respiration, with bilateral rhonchi throughout the lung fields...
February 23, 2018: Journal of Emergency Medicine
Changwan Ryu, Daniel Boffa, Kyle Bramley, Margaret Pisani, Jonathan Puchalski
RATIONALE: Airway stabilization for severe, symptomatic tracheobronchomalacia (TBM) may be accomplished by silicone Y-stent placement. Common complications of the Y-stent include mucus plugging and granulation tissue formation. PATIENT CONCERNS: We describe a rare case of massive hemoptysis originating from a silicone Y-stent placed for TBM. DIAGNOSES: An emergent bronchoscopy showed an actively bleeding, pulsatile vessel at the distal end of the left bronchial limb of the Y-stent...
February 2018: Medicine (Baltimore)
Leonardo Donato, Thi Mai Hong Tran, Uzair K Ghori, Ali I Musani
Although controversy over the role of flexible versus rigid bronchoscopy for airway foreign body management persists, the effort should focus on prevention of aspiration of foreign bodies instead. This article discusses several recent advances in the bronchoscopic management of congenital tracheal stenosis, pediatric airway stenting, and the use of different types of lasers in children. The lack of randomized clinical trials leaves pediatric interventional bronchoscopic procedures without much national or international standards or guidelines...
March 2018: Clinics in Chest Medicine
Antoinette Flannery, Cyrus Daneshvar, Hervé Dutau, David Breen
Interventional pulmonology has grown significantly over the last 2 decades and is now seen as an essential component in thoracic oncology care. The rigid bronchoscope occupies a central role in this specialty and offers many important advantages over the flexible scope when performing therapeutic procedures on central airways. Although stenting practices have evolved, it is generally accepted that stents offer an important treatment option for selected patients with benign and malignant airway diseases. This article discusses rigid bronchoscopy and stenting, future challenges, complications of the procedure and stents, and future directions...
March 2018: Clinics in Chest Medicine
Jeanine Blatter, Thorsten Krueger, Hans-Beat Ris, Moira Baeriswyl, Alban Lovis, Mathieu Zellweger, Michel Gonzalez, Jean Yannis Perentes
BACKGROUND: Extrathoracic muscle flaps can be used as airway substitutes for the closure of complex broncho-pleural or tracheo-esophageal fistulas or in the context of tracheo-carinal reconstructions after resection for centrally localized tumors in order to alleviate excess anastomotic tension. METHODS: Evaluation of all patients undergoing tracheo-carinal reconstructions with extrathoracic muscle flap patches as airway substitutes in our institution from 1996 to 2016...
February 7, 2018: Annals of Thoracic Surgery
Wen-Jue Soong, Pei-Chen Tsao, Yu-Sheng Lee, Chia-Feng Yang
OBJECTIVES: To assess the placement, surveillance management and long-term outcomes of the tracheobronchial (TB) balloon expandable metallic stent (BEMS) managed by therapeutic flexible endoscopy (TFE). METHODS: This is a retrospective review and analysis of all computerized medical records and related flexible endoscopy videos of pediatric patients who received TB BEMS during 20 years period, from January 1997 to December 2016. TFE techniques with forceps debridement, balloon dilatation and laser ablation were used to implant stents, perform regular surveillance, maintain their functions, and expand the diameters of BEMS...
2018: PloS One
Sameh I Sersar, Lamees A Maghrabi
Background Aerodigestive fistulae can be defined as abnormal communications between the gastrointestinal tract and the respiratory tract. Choking after meals, coughing, feeding difficulties, tachycardia, and persistent pneumonia are the main presentations. The aim of our study was to review our experience in the management of 27 cases of acquired aerodigestive fistulae of different types, levels, and management. Methods We conducted a retrospective observational study on 27 cases of fistulae between the respiratory and digestive tracts, which were managed in 2 hospitals in Saudi Arabia in the last 5 years...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
Ting Wang, Jie Zhang, Xiao-Jian Qiu, Juan Wang, Ying-Hua Pei, Yu-Ling Wang
BACKGROUND: Scarring airway stenosis is commonly seen in China as compared to other developed countries, due to the high prevalence of tuberculosis. Nowadays, interventional bronchoscopy treatment has been widely used to treat this disease in China. This study demonstrated the characteristics of scarring airway stenosis in Chinese adults and retrospectively evaluated the efficacy of interventional bronchoscopy treatment of this disease. METHODS: Patients with scarring airway stenosis from 18 tertiary hospitals were enrolled between January 2013 and June 2016...
February 5, 2018: Chinese Medical Journal
Daisuke Taniguchi, Keitaro Matsumoto, Tomoshi Tsuchiya, Ryusuke Machino, Yosuke Takeoka, Abdelmotagaly Elgalad, Kiyofumi Gunge, Katsunori Takagi, Yasuaki Taura, Go Hatachi, Naoto Matsuo, Naoya Yamasaki, Koichi Nakayama, Takeshi Nagayasu
OBJECTIVES: Currently, most of the artificial airway organs still require scaffolds; however, such scaffolds exhibit several limitations. Alternatively, the use of an autologous artificial trachea without foreign materials and immunosuppressants may solve these issues and constitute a preferred tool. The rationale of this study was to develop a new scaffold-free approach for an artificial trachea using bio-3D printing technology. Here, we assessed the circumferential tracheal replacement using scaffold-free trachea-like grafts generated from isolated cells in an inbred animal model...
January 15, 2018: Interactive Cardiovascular and Thoracic Surgery
Ravindra M Mehta, Abhinav Singla, Rajani S Bhat, Rakesh Godara, Chakravarthi Lokanath, Michael Cutaia
BACKGROUND: Prolonged air leak (PAL) is a life-threatening condition that can present either as bronchopleural fistula, or alveolar-pleural fistula (APF). Although numerous bronchoscopic treatments are described, they are either expensive, not widely available in the developing world or have limited success. We describe our experience with a novel customized endobronchial silicone blocker (CESB) for PAL treatment. METHODS: This is a retrospective study of PAL patients who underwent CESB placement...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
Giselle Cuestas, Verónica Rodríguez, Flavia Doormann, Patricio Bellia Munzón, Gastón Bellia Munzón
Bronchial obstruction is infrequent in the child. The main cause is malacia or benign stenosis. Management alternatives range from conservative treatment to complex surgical and/or endoscopic techniques. Placement of a stent can play a key role in situations where there is no other therapeutic option. However, the ideal stent is not yet available. In the last few years, progress has been made in the development and characterization of novel biodegradable materials in order to overcome the drawbacks of traditional stents made of silicone or metal...
February 1, 2018: Archivos Argentinos de Pediatría
J-H Zhu, M Lei, E-G Chen, Q Qiao, T-D Zhong
BACKGROUND: Stenting of airway stenosis is a common procedure in specialized centers. The aim of this study was to summarize our clinical experience in ventilation strategy and anesthesia management of patients undergoing urgent tracheal stenting. METHODS: Clinical data of 22 patients with severe tracheal stenosis who underwent urgent endoscopic placement of a tracheal stent during a 2-year period were retrospectively reviewed. The efficacy and safety of different ventilation strategies and veno-arterial extracorporeal membrane oxygenation (ECMO), individualized based on the cause and location of tracheal narrowing, were evaluated...
January 7, 2018: Acta Anaesthesiologica Scandinavica
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