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Endobronchial Stent

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https://www.readbyqxmd.com/read/28740687/infections-causing-central-airway-obstruction-role-of-bronchoscopy-in-diagnosis-and-management
#1
REVIEW
Sevak Keshishyan, Lawrence DeLorenzo, Kassem Hammoud, Arpine Avagyan, Hussein Assallum, Kassem Harris
Central airway obstructive infections (CAOI) are challenging medical conditions that may represent an advanced and complicated process of ongoing infections. The epidemiology of CAOI is unknown as well as the pathophysiology and the mechanism of development. This is due to sparse data in the literature that consists mainly of case reports and retrospective case series. CAOI can be caused by fungal, bacterial, parasitic and viral infections. Most patients with CAOI can be diagnosed clinically and with chest imaging, which demonstrate obstruction of the central airways...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28697892/bronchopleural-fistula-after-pneumonectomy-risk-factors-and-management-focusing-on-open-window-thoracostomy
#2
Antonio Mazzella, Alessandro Pardolesi, Patrick Maisonneuve, Francesco Petrella, Domenico Galetta, Roberto Gasparri, Lorenzo Spaggiari
OBJECTIVE: To evaluate principal risk factors and different therapeutic approaches for postpneumonectomy bronchopleural fistula (BPF), focusing on open window thoracostomy (OWT). METHODS: We retrospectively reviewed all patients treated by pneumonectomy for lung cancer between 1999 and 2014. We evaluated preoperative, operative, and postoperative data; interval between operation and fistula formation; and size, treatment, and predicting factors of BPF. Cumulative incidence curves for the development of BPF were drawn according to the Kaplan-Meier method...
June 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28685656/a-combined-technique-using-a-muscular-flap-and-endobronchial-stent-to-repair-complex-broncho-oesophageal-fistulae-supported-by-ecmo
#3
Jean-Marc Baste, Laura Haddad, Guillaume Philouze
INTRODUCTION: Certain broncho-oesophageal fistulae require surgical repair. Herein, we describe an innovative surgical technique combining intercostal flap and endobronchial stenting. CASE REPORTS: Two patients, each with a with complex broncho-oesophageal fistula 2 years after radio-chemotherapy, were hospitalised for severe respiratory infection and extension of the fistula despite previous endoscopic treatment. The first patient presented with respiratory distress (ARDS)...
July 7, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28681367/expandable-metallic-stent-for-endobronchial-metastasis-from-colorectal-cancer-reports-of-2-cases
#4
Tomoki Nakamura, Takayuki Tajima, Takashi Ogimi, Hiroshi Miyakita, Miho Nitta, Kazunori Myojin, Sakurako Tajiri, Ichiro Kobayashi, Takayuki Nishi, Sotaro Sadahiro, Hideo Shimada
In recent years, there have been many reports about the efficacy of stenting for central bronchial stenosis. When central bronchial stenosis is due to metastasis of a malignant tumor to the trachea and/or bronchi (endobronchial metastasis: EM), it is classified as "narrow EM" and "broad EM." [1] We managed two patients in whom bilateral stent placement was required for narrow and broad EM arising from colorectal cancer. Case 1: In September 2011, a 66-year-old man underwent low anterior resection for advanced colorectal cancer associated with unresectable liver metastasis...
July 20, 2017: Tokai Journal of Experimental and Clinical Medicine
https://www.readbyqxmd.com/read/28579789/a-retrograde-y-stenting-of-the-trachea-for-treatment-of-mediastinal-fistula-in-an-unusual-situation
#5
Wolfgang Hohenforst-Schmidt, Paul Zarogoulidis, Michael Steinheimer, Thomas Schneider, Naim Benhassen, Holger Rupprecht, Lutz Freitag
INTRODUCTION: Stents have been used for quite some time for the treatment of benign and malignant airway stenosis. Silicon stents are preferred for benign situations, whereas metallic self-expanding stents are preferred for malignant comorbidities. PATIENT AND METHODS: In general, stents can be placed in different approach directions, although in pulmonary medicine it is logical to apply only antegrade techniques - until now. A 63-year-old patient, 168 cm height and 53 kg weight on referral, suffered chronical diseases...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28538215/the-use-of-polyvinyl-alcohol-sponge-and-cyanoacrylate-glue-in-the-treatment-of-large-and-chronic-bronchopleural-fistulae-following-lung-cancer-resection
#6
Paolo Battistoni, Umberto Caterino, Sandro Batzella, Raffaele Dello Iacono, Gabriele Lucantoni, Giovanni Galluccio
BACKGROUND: Bronchopleural fistulae represent a relatively rare complication of pulmonary resection. For inoperable patients, several endoscopic procedures have been described. In the presence of large and chronic bronchopleural fistulae, persistent air leaks require a surgical therapy, while endoscopic airway stent represents a useful palliative treatment. OBJECTIVE: We describe the successful closure of large and chronic bronchopleural fistulae using an expandable polyvinyl alcohol (PVA) sponge and cyanoacrylate glue...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28527920/emerging-bronchoscopic-treatments-for-chronic-obstructive-pulmonary-disease
#7
REVIEW
Wouter H van Geffen, Huib A M Kerstjens, Dirk-Jan Slebos
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by pathophysiological factors including airflow limitation, hyperinflation and reduced gas exchange. Treatment consists of lifestyle changes, lung rehabilitation and pharmacological therapies such as long acting beta-2-agonists (LABA) and long acting muscarinic antagonists (LAMA). More recently bronchoscopic treatments are emerging for COPD. Among them endobronchial valves(EBV) and endobronchial coils (EBC), next to endobronchial stents, sclerosing agents, targeted lung denervation and liquid nitrogen metered cryospray...
May 17, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28396722/laparoscopic-retrosternal-gastric-pull-up-for-fistulized-mediastinal-mass
#8
Benedetto Mungo, Arianna Barbetta, Anne O Lidor, Miloslawa Stem, Daniela Molena
We describe the case of a patient successfully reconstructed with laparoscopic retrosternal gastric pull-up after esophagectomy for unresectable posterior mediastinal inflammatory myofibroblastic tumor, eroding into the esophagus and compressing the airways. A partial esophagectomy with esophagostomy was performed for treatment of esophageal pleural fistula and empyema, while the airways were managed with the placement of an endobronchial stent. Gastrointestinal reconstruction was performed using a laparoscopic approach to create a retrosternal tunnel for gastric conduit pull-up and cervical anastomosis...
March 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28391759/current-treatment-of-tracheoesophageal-fistula
#9
Changzhi Zhou, Yi Hu, Yang Xiao, Wen Yin
Tracheoesophageal fistulas (TEFs) often occur with esophageal or bronchial carcinoma. Currently, we rely on implantation of delicate devices, such as self-expanding and silicone stents, in the esophagus or trachea to cover the fistula and expand the stenosis in order to relieve patient pain. However, because each case is different, our approach may not be effective for every patient. Consequently, new devices and technology have emerged to address these situations, such as degradable stents, Amplatzer(®) devices, endobronchial one-way umbrella-shaped valves, and transplantation of mesenchymal stem cells...
April 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28298961/transplant-pulmonary-interventions-translating-lung-transplant-interventions-to-nontransplant-patients
#10
REVIEW
Neeraj Sinha
Roughly 10% of lung transplant recipients experience airway complications. Although the incidence has decreased dramatically since the first lung transplants were performed in the 1960s, airway complications have continued to adversely affect outcomes. Bronchoscopic interventions such as balloon dilation, airway stenting, and endobronchial electrocautery play an important role in ameliorating the morbidity and mortality associated with these complications. This review describes the array of bronchoscopic interventions used to treat airway complications after lung transplant and how these techniques can be used in nontransplant settings as well...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28230230/bronchoscopic-lung-volume-reduction-procedures-for-chronic-obstructive-pulmonary-disease
#11
REVIEW
Joseph Em van Agteren, Khin Hnin, Dion Grosser, Kristin V Carson, Brian J Smith
BACKGROUND: In the recent years, a variety of bronchoscopic lung volume reduction (BLVR) procedures have emerged that may provide a treatment option to participants suffering from moderate to severe chronic obstructive pulmonary disease (COPD). OBJECTIVES: To assess the effects of BLVR on the short- and long-term health outcomes in participants with moderate to severe COPD and determine the effectiveness and cost-effectiveness of each individual technique. SEARCH METHODS: Studies were identified from the Cochrane Airways Group Specialised Register (CAGR) and by handsearching of respiratory journals and meeting abstracts...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28195963/mediastinitis-following-endobronchial-ultrasound-guided-transbronchial-needle-aspiration
#12
Aruna Jahoor, Shekhar Ghamande, Shirley Jones, Carl Boethel, Heath D White
Mediastinitis is a rare complication of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Recent reports of infectious complications following EBUS-TBNA involved oropharyngeal bacteria. Here, we report 2 unusual cases of post-EBUS-TBNA mediastinitis involving Streptococcus pneumoniae and Pseudomonas aeruginosa, which were likely the result of direct inoculation of the organisms at the time of transbronchial needle aspiration. The first case was successfully treated with computed tomography-guided drainage and antibiotics, whereas the second case had >50% distal tracheal obstruction and near total occlusion of the left main stem bronchus, requiring rigid bronchoscopy, stent placement, debulking, and antibiotics...
February 10, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28031841/long-term-outcome-of-nitinol-stenting-to-treat-asphyxia-caused-by-postpneumonectomy-syndrome
#13
Jiro Abe, Toru Hasumi, Ryota Tanaka, Yasuki Saito, Keishi Kanma, Satomi Takahashi
The long-term outcome of nitinol stents introduced into a patient with postpneumonectomy syndrome is described. Postpneumonectomy syndrome is a rare but crucial complication after pneumonectomy characterized by severe dyspnoea and recurrent airway infection caused by compression of the main bronchus. Surgical correction of mediastinal displacement and endobronchial stent placement are two major treatments for this complication; however, endobronchial stenting may be limited to those who are not suitable for operative procedures because long-term management is difficult in terms of controlling airway infections...
January 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28018811/management-of-postintubational-tracheal-injury-by-endoscopic-stent-placement-case-report-and-review-of-the-literature
#14
Christian Geltner, Rudolf Likar, Klaus Hausegger, Markus Rauter
Endobronchial stent placement is a novel therapy for treatment of iatrogenic tracheal tears. A review of the available literature shows surgery and long-term intubation being the established treatment strategy. We describe the case of a 64-year-old woman with a tracheal rupture following endotracheal intubation for routine surgery. Pneumo-mediastinum and chest pain were the predominant symptoms. She was treated with a covered self-expandable metal stent that closed the tear and led to immediate symptom relief...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/27679445/pulmostent-in-vitro-to-in-vivo-evaluation-of-a-tissue-engineered-endobronchial-stent
#15
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...
April 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/27479014/an-expectorated-stent-an-unexpected-complication-of-ebus-tbna
#16
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 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/27424824/rigid-bronchoscopic-intervention-for-endobronchial-metastasis-of-renal-cell-carcinoma
#17
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
https://www.readbyqxmd.com/read/27343540/extracorporeal-lung-support-as%C3%A2-a%C3%A2-bridge-to-airway-stenting%C3%A2-and%C3%A2-radiotherapy-for%C3%A2-airway-obstructing-pancoast%C3%A2-tumor
#18
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
https://www.readbyqxmd.com/read/27281104/therapeutic-bronchoscopic-interventions-for-malignant-airway-obstruction-a-retrospective-study-from-experience-on-547-patients
#19
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)
https://www.readbyqxmd.com/read/27197344/removal-of-endobronchially-placed-vascular-self-expandable-metallic-stent-using-flexible-bronchoscopy
#20
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
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