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Endobronchial Stent

Anja Lena Thiebes, Nicola Kelly, Caoimhe A Sweeney, Donnacha J McGrath, Johanna Clauser, Kathrin Kurtenbach, Valentine N Gesche, Weiluan Chen, Robbert Jan Kok, Ulrich Steinseifer, Mark Bruzzi, Barry J O'Brien, Peter E McHugh, Stefan Jockenhoevel, Christian G Cornelissen
Currently, there is no optimal treatment available for end stage tumour patients with airway stenosis. The PulmoStent concept aims on overcoming current hurdles in airway stenting by combining a nitinol stent with a nutrient-permeable membrane, which prevents tumour ingrowth. Respiratory epithelial cells can be seeded onto the cover to restore mucociliary clearance. In this study, a novel hand-braided dog bone stent was developed, covered with a polycarbonate urethane nonwoven and mechanically tested. Design and manufacturing of stent and cover were improved in an iterative process according to predefined requirements for permeability and mechanical properties and finally tested in a proof of concept animal study in sheep for up to 24 weeks...
September 27, 2016: Annals of Biomedical Engineering
Felix D Zamora, Anas Moughrabieh, Heidi Gibson, Eitan Podgaetz, H Erhan Dincer
Endobronchial ultrasound-guided transbronchial needle aspiration has a low complication rate and is a cost-effective procedure for mediastinal staging and diagnosis when compared with the more invasive mediastinoscopy. There are increasing case reports of unexpected complications including equipment failures with and without significant medical consequences. Knowledge of complications, including those that are rare, is essential for the physician performing this minimally invasive procedure. We report a case of a retained foreign body from the unexpected separation of a distal spring/coil mechanism from the Olympus ViziShot Aspiration needle following early needle deployment within the working channel of the bronchoscope...
July 29, 2016: Journal of Bronchology & Interventional Pulmonology
Rie Tsuboi, Masahide Oki, Hideo Saka, Yoshihito Kogure, Saori Oka, Masashi Nakahata, Kazumi Hori, Yasushi Murakami, Yuko Ise, Shimaa Nour Moursi Ahmed, Meimei Tao, Chiyoe Kitagawa
BACKGROUND: Renal cell carcinoma is one of the major endobronchial metastases, and it occasionally causes life-threatening airway obstruction. Rigid bronchoscopy is useful as a palliative intervention; however, its utility for metastatic renal cell carcinoma has not been elucidated. The purpose of this study was to evaluate the safety and efficacy of rigid bronchoscopic treatment for endobronchial metastasis of renal cell carcinoma. METHODS: Among 550 patients who underwent rigid bronchoscopic intervention at a single center from January 2005 to June 2015, 9 with metastatic renal cell carcinoma were retrospectively reviewed...
July 2016: Respiratory Investigation
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
Levent Dalar, Cengiz Özdemir, Yasin Abul, Levent Karasulu, Sinem Nedime Sökücü, Ayşegül Akbaş, Sedat Altn
There is no definitive consensus about the factors affecting the choice of interventional bronchoscopy in the management of malignant airway obstruction. The present study defines the choice of the interventional bronchoscopic modality and analyzes the factors influencing survival in patients with malignant central airway obstruction. Totally, over 7 years, 802 interventional rigid bronchoscopic procedures were applied in 547 patients having malignant airway obstruction. There was a significant association between the type of stent and the site of the lesion in the present study...
June 2016: Medicine (Baltimore)
Karol Kremens
Self-expanding metallic stents (SEMS) are commonly placed in malignant airway obstruction and sometimes in benign obstruction. Complications from SEMS placement are common, especially after 30 days from deployment. SEMS removal can be complicated and often involves significant resources. We report a case of a 78-year-old man with small cell carcinoma who underwent placement of a Luminexx endovascular stent in his right main stem bronchus, complicated by stent migration after initiation of chemotherapy. Stent removal was performed by flexible bronchoscopy, utilizing forceps inserted via a working channel, as well as a goose neck snare operated parallel to the bronchoscope...
April 2016: WMJ: Official Publication of the State Medical Society of Wisconsin
R Scheubel
BACKGROUND: Chronic mediastinitis is a rare disorder characterized by the proliferation of fibrous tissue within the mediastinum resulting in compression of mediastinal structures. OBJECTIVE: This article gives an overview of the treatment options for chronic mediastinitis. MATERIAL AND METHODS: A literature search was carried out regarding treatment options for chronic mediastinitis RESULTS AND CONCLUSION: Little is known about the pathogenesis of chronic mediastinitis, which has hampered the development of novel therapeutic approaches...
June 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Cengiz Özdemir, Sinem Nedime Sökücü, Levent Karasulu, Seda Tural Önür, Levent Dalar
BACKGROUND: Self-expandable metallic stents (SEMS) can be used to treat malignant obstructions and fistulas of the central airways. SEMS can be placed using different methods. Recently, a rigid bronchoscope has been used for stent placement without the need for fluoroscopy. We retrospectively evaluated patients for whom SEMS were placed using a rigid bronchoscope, without employing guidewires or fluoroscopy. We describe the intra- and post-procedural complications of the method. METHODS: Data collected between January 2014 and July 2015 were retrospectively evaluated by reference to hospital records...
2016: Multidisciplinary Respiratory Medicine
Mohamed Faisal, Hafaruzi Harun, Tidi M Hassan, Andrea Y L Ban, Sanjay H Chotirmall, Jamalul Azizi Abdul Rahaman
BACKGROUND: Tracheobronchial stenosis is a known complication of endobronchial tuberculosis. Despite antituberculous and steroid therapy, the development of bronchial stenosis is usually irreversible and requires airway patency to be restored by either bronchoscopic or surgical interventions. We report the use of balloon dilatation and topical mitomycin-C to successful restore airway patency. CASE PRESENTATION: We present a 24-year old lady with previous pulmonary tuberculosis and laryngeal tuberculosis in 2007 and 2013 respectively who presented with worsening dyspnoea and stridor...
2016: BMC Pulmonary Medicine
Abdul Hamid Alraiyes, Kassem Harris, Samjot Singh Dhillon
No abstract text is available yet for this article.
March 2016: Endoscopic Ultrasound
Felix J F Herth, Ralf Eberhardt
PURPOSE OF REVIEW: Patients with lung cancer often develop endobronchial disease, endobronchial tumor extension or airway compression. Various nonmalignant diseases can also lead to severe central airway obstruction.Since the early 1980s, technical advances of interventional bronchoscopic techniques have improved symptom-free survival and quality of life for patients with lung cancer. Apart from other techniques, various airway stents have been developed. Although interventional procedures are not definitive therapies, they often relieve the strangling sensation produced by airway occlusion...
May 2016: Current Opinion in Pulmonary Medicine
Levent Dalar, Cengiz Özdemir, Sinem Nedime Sökücü, Levent Karasulu, Sedat Altın
BACKGROUND: Endobronchial metastases (EBM) are rarely observed, but they are caused by a number of different tumors. Bronchoscopy is the main approach for both differential diagnosis and to maintain endoluminal palliation. In this study, consecutive EBM cases that had been diagnosed and treated were evaluated in a retrospective cohort. METHODS: In total, 18 pathologically verified patients with EBM originating from extrathoracic tumors who were referred to our interventional pulmonology unit with respiratory symptoms were retrospectively evaluated...
March 2016: Respiratory Investigation
Guo-Wu Zhou, Hai-Dong Huang, Qin-Ying Sun, Ye Xiong, Qiang Li, Yu-Chao Dong, Wei Zhang
BACKGROUND: The permanent placement of metallic stent for benign tracheobronchial stenosis (BTS) was controversial. This study was conducted to evaluate the long-term outcomes of temporary placement of metallic stent for BTS. METHODS: The BTS patients who received temporary placement of retrievable self-expanded metallic stents were included between 2008 and 2011. Pre-stenting and follow-up respiratory status was analyzed. And symptom recurrence-free survival (SRFS) was assessed...
December 2015: Journal of Thoracic Disease
Ashutosh Sachdeva, Edward M Pickering, Hans J Lee
Over the past decade, there has been significant advancement in the development/application of therapeutics in thoracic diseases. Ablation methods using heat or cold energy in the airway is safe and effective for treating complex airway disorders including malignant and non-malignant central airway obstruction (CAO) without limiting the impact of future definitive therapy. Timely and efficient use of endobronchial ablative therapies combined with mechanical debridement or stent placement results in immediate relief of dyspnea for CAO...
December 2015: Journal of Thoracic Disease
Narin Sriratanaviriyakul, Lam-Phuong Nguyen, Heba Ismail, Rolando F Roberto, Ken Y Yoneda
Kyphoscoliosis is known to compromise lung function, with the primary mechanism being reduced chest wall compliance with a resultant restrictive pulmonary physiology. Severe scoliosis can also cause extrinsic compression of the central airways, leading to recurrent respiratory infections, lobar atelectasis, and potentially acute respiratory failure. Definitive therapy is corrective surgery of the spine. However, patients with severe scoliosis are at a potentially high risk of perioperative pulmonary complications...
October 22, 2015: Journal of Bronchology & Interventional Pulmonology
Roberto Miraglia, Patrizio Vitulo, Luigi Maruzzelli, Gaetano Burgio, Settimo Caruso, Alessandro Bertani, Adriana Callari, Angelo Luca
Airway stenosis is a major complication after lung transplantation that is usually managed with a combination of interventional endoscopic techniques, including endobronchial debridement, balloon dilation, and stent lacement. Herein, we report a successful case of recanalization of a complete stenosis of the right middle lobe bronchus in a lung transplant patient, by using a combined percutaneous–bronchoscopic approach after the failure of endobronchial debridement.
March 2016: Cardiovascular and Interventional Radiology
Beatriz Amaral, Salvato Feijó
Postoperative bronchopleural fistulas are serious and uncommon complications after pneumonectomy. Available therapeutic approaches are medical, endoscopic, and/or surgical. A 42-year-old man underwent left pneumonectomy. Three years later he was admitted to an intensive care unit with pneumonia of the remaining lung, severe respiratory insufficiency, and a bronchopleural fistula with an air fluid level filling in the pneumonectomy cavity. A left chest drain was placed, and broad-spectrum antibiotics and mechanical ventilation were administered...
October 2015: Journal of Bronchology & Interventional Pulmonology
B Huret, T Perez, X Dhalluin, F Dewavrin, P-P Ramon, C Fournier
INTRODUCTION: Endobronchial resection is now the standard treatment for tracheobronchial narrowing due to malignancy. The clinical and functional respiratory improvement has been evaluated previously but only in heterogeneous population. METHODS: Between February 2009 and February 2011, we conducted a prospective single centre study at the University Hospital of Lille. Twenty-five patients with malignant tracheobronchial stenosis received a clinical and functional respiratory evaluation before and after a rigid bronchoscopy procedure to reduce the obstruction followed where appropriate by placement of an endobronchial stent...
May 2015: Revue des Maladies Respiratoires
Yiu-Hei Ching, Robert D Geck, Arthur D Andrews, Mark J Rumbak, Enrico M Camporesi
Endotracheal and endobronchial stenting, particularly with uncovered stents, can be complicated by stent fracture, granulation tissue formation, direct airway injury, and airway obstruction. While stent removal is possible, it can result in significant complications and long-term benefit is not guaranteed. Argon plasma coagulation can be employed to trim fractured stent fragments and remove granulation tissue simultaneously. In this manuscript, we report a case and describe our experience with using this technique...
2014: Respiratory Medicine Case Reports
Tanmay S Panchabhai, Atul C Mehta
The era of bronchoscopy began with Gustav Killian in 1876 when he removed a pork bone from a farmer's airway, using an esophagoscope. Prompted by this accomplishment, Chevalier Jackson, an American otolaryngologist, laid the platform for the modern-day rigid bronchoscope in the early twentieth century. In 1967 Shigeto Ikeda revolutionized the field of bronchoscopy by his innovation of the fiberoptic bronchoscope. Today, bronchoscopy and interventional pulmonology have become an integral part of pulmonary medicine and an established subspecialty...
May 2015: Annals of the American Thoracic Society
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