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https://www.readbyqxmd.com/read/28523137/complex-multimodality-central-airway-management-of-aspergillus-pseudomembranous-tracheobronchitis
#1
Samjot Singh Dhillon, Marwan Saoud, Kassem Harris
A 69-year-old woman developed central airway obstruction due to invasive Aspergillus infection resulting in pseudomembranous tracheobronchitis (PTB). Several challenges were encountered in the airway management of this patient including her having relatively smaller airways which were more prone to obstruction by pseudomembranes and made airway interventions difficult. The patient had clinical deterioration in spite of antifungal therapy and bronchoscopic debridement. The multimodality airway techniques included the use of smaller biliary balloons for dilatation, using a hybrid stent to slowly dilate and maintain patency of right main stem and finally the insertion of right secondary carina peripheral Y stent, which resulted in clinical improvement and allowed time for antifungal therapy to take effect...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28474657/tracheal-stenting-under-flexible-bronchoscopy-for-large-tracheoesophageal-malignant-lymphadenopathy
#2
Irfan Ismail Ayub, Kalaichelvi Kannan, R Dhenesh, Anand Thiagarajan
A 67-year-old man with poorly controlled chronic obstructive pulmonary disease presented with progressive dysphagia and was diagnosed with locally advanced carcinoma of the esophagus. Positron emission tomography-computed tomography staging showed mediastinal lymphadenopathy including a large lymph node in the tracheoesophageal groove with moderate tracheal compression. He was advised chemoradiotherapy but was reluctant to proceed with the same. He developed stridor 2 months later and repeat imaging showed increased size of the tracheoesophageal lymph node with critical airway narrowing...
May 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28449509/rapid-response-in-a-critical-lung-adenocarcinoma-presenting-as-large-airway-stenoses-after-receiving-stent-implantation-and-sequential-rebiopsy-guided-alk-inhibitor-therapy-a-case-report
#3
Ling Ding, Cheng Chen, Yuan-Yuan Zeng, Jian-Jie Zhu, Jian-An Huang, Ye-Han Zhu
Airway stent implantation can improve the symptoms of airway stenosis caused by a malignant tumor immediately. However, stent implantation is only a palliative therapy and disease will quickly progress without subsequent treatment. Targeted therapy can provide accurate etiological treatment for patients with critical lung cancer who cannot receive chemotherapies. In our clinic, we encountered a 50-year-old male presenting with stage IV lung adenocarcinoma. He failed both the first-line and second-line chemotherapies and suffered severe complex left and right main bronchial stenoses caused by tumor invasion...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28448981/safety-and-efficacy-of-a-fully-covered-self-expandable-metallic-stent-in-benign-airway-stenosis
#4
Marc Fortin, Yves Lacasse, Xavier Elharrar, Rachid Tazi-Mezalek, Sophie Laroumagne, Julien Guinde, Philippe Astoul, Hervé Dutau
BACKGROUND: The use of self-expandable metallic stents (SEMS) in benign airway disease was the object of a boxed warning from the United States Food and Drug Administration in 2005 due to the risk of stent-related complications and difficulties associated with their removal. Third-generation fully covered SEMS have been commercialized since this warning and theoretically should not present the same difficulties associated with removal as they cannot become embedded in the airway mucosa...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28446974/stents-for-airway-strictures-selection-and-results
#5
REVIEW
Adil Ayub, Adnan M Al-Ayoubi, Faiz Y Bhora
Airway stents can provide effective and timely relief in patients with central airway obstruction. Silicone based stents are the most commonly used airway stents worldwide with a long track record of safety. Metallic stents continue to evolve from the earliest uncovered versions to a variety of newly designed covered stents. Despite the availability of a variety of stent materials and designs, minimal advances have been made towards innovation in stent technology and an ideal stent has unfortunately not yet been developed...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28424763/airway-problems-in-neonates-a-review-of-the-current-investigation-and-management-strategies
#6
REVIEW
Quen Mok
Airway problems in the neonatal population are often life threatening and raise challenging issues in diagnosis and management. The airway problems can result from congenital or acquired lesions and can be broadly classified into those causing obstruction or those due to an abnormal "communication" in the airway. Many different investigations are now available to identify the diagnosis and quantify the severity of the problem, and these tests can be simple or invasive. Bronchography and bronchoscopy are essential to determine the extent and severity of the airway problem and to plan treatment strategy...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28421364/an-ovine-in-vivo-framework-for-tracheobronchial-stent-analysis
#7
Donnacha J McGrath, Anja Lena Thiebes, Christian G Cornelissen, Mary B O'Shea, Barry O'Brien, Stefan Jockenhoevel, Mark Bruzzi, Peter E McHugh
Tracheobronchial stents are most commonly used to restore patency to airways stenosed by tumour growth. Currently all tracheobronchial stents are associated with complications such as stent migration, granulation tissue formation, mucous plugging and stent strut fracture. The present work develops a computational framework to evaluate tracheobronchial stent designs in vivo. Pressurised computed tomography is used to create a biomechanical lung model which takes into account the in vivo stress state, global lung deformation and local loading from pressure variation...
April 19, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28419806/tracheal-t-tubes-for-long-term-management-of-the-unreconstructable-trachea-in-adults
#8
Mark A Varvares
Management of tracheostenosis in adult patients who are either medically unreconstructable due to significant comorbidities or surgically unreconstructable remains a challenge. The tracheal T-tube offers an excellent permanent solution to the problem of the unreconstructable trachea. This article reviews 3 patients who underwent tracheofissure and placement of a tracheal T-tube after failed prior attempts at repair of tracheal stenosis. The tracheal T-tubes have been maintained for 13, 15, and 36 years, and these patients have enjoyed adequate phonatory and respiratory functions with the T-tube plugged and functioning as an airway stent...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28409444/locally-invasive-thyroid-cancer-options-for-a-treatment
#9
Nicola Avenia, Jacopo Vannucci, Massimo Monacelli, Andrea Polistena, Francesco Puma
Local invasion to neighbor organs by thyroid cancer is an important prognosticator and requires different therapeutic approach. Which one is the possible best treatment option and results are evaluated in this study. A single-institution experience in thyroid cancer invading the airway is evaluated retrospectively (1990-2016). Facts regarding patients' demographics, disease history, comorbidities, condition at first evaluation and reason for referral are analyzed. Hospital records and treatment details are extracted from charts and Institutional folders...
April 13, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28397555/pyriform-aperture-stenosis-a-novel-approach-to-stenting
#10
Aaron Smith, Amanda Kull, Prasad Thottam, Anthony Sheyn
OBJECTIVES: Congenital nasal pyriform aperture stenosis (CNPAS) is one of several causes of neonatal respiratory distress. Congenital nasal pyriform aperture stenosis can be diagnosed by clinical presentation and evaluated by computed tomography for degree of stenosis. Surgical management of indicated cases involves drillout of pyriform aperture with placement of stents. The following case presents a novel approach to choice of stent in these patients. CASE PRESENTATION: We report the case of an infant diagnosed with CNPAS who underwent surgical correction at 9 days of life, with placement of mometasone fuorate stents...
June 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28396722/laparoscopic-retrosternal-gastric-pull-up-for-fistulized-mediastinal-mass
#11
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/28389860/a-novel-self-expandable-radioactive-airway-stent-loaded-with-125-i-seeds-a-feasibility-and-safety-study-in-healthy-beagle-dog
#12
Yong Wang, Jin-He Guo, Guang-Yu Zhu, Hai-Dong Zhu, Li Chen, Jian Lu, Chao Wang, Gao-Jun Teng
PURPOSE: Airway stent placement is an effective treatment for the immediate palliation of malignant airway obstruction. However, restenosis caused by tumor ingrowth and/or overgrowth after stenting is common. The purpose of this study was to investigate the feasibility and safety of a novel self-expandable stent loaded with (125)I seeds in healthy beagle dog. MATERIALS AND METHODS: Under fluoroscopic guidance, forty-eight self-expandable airway stents loaded with (125)I seeds were perorally placed in the main trachea of 48 healthy beagle dogs, who were randomly divided into four groups (Group A: 0...
April 7, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28371091/novel-magnetic-resonance-imaging-for-assessment-of-bronchial-stenosis-in-lung-transplant-recipients
#13
Kamran Mahmood, Lukas Ebner, Mu He, Scott Haile Robertson, Ziyi Wang, H Page McAdams, Momen M Wahidi, Scott L Shofer, Yuh-Chin T Huang, Bastiaan Driehuys
Bronchial stenosis in lung transplant recipients is a common disorder that adversely affects clinical outcomes. It is evaluated by spirometry, CT scan and bronchoscopy with significant limitations. We hypothesize that magnetic resonance imaging (MRI) employing both ultrashort echo time (UTE) scans and hyperpolarized (HP) (129) Xe gas can offer structural and functional assessment of bronchial stenosis seen after lung transplantation. Six patients with lung transplantation-related bronchial stenosis underwent HP (129) Xe MRI and UTE MRI...
March 29, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28360477/bronchoscopic-management-of-critical-central-airway-obstruction-by-thyroid-cancer-combination-airway-stenting-using-tracheal-and-inverted-y-carinal-self-expanding-metallic-stents
#14
Karan Madan, Prajowl Shrestha, Rakesh Garg, Vijay Hadda, Anant Mohan, Randeep Guleria
Central airway obstruction (CAO) can result from various benign and malignant etiologies. Anaplastic thyroid cancer (ATC) is the most aggressive form of thyroid cancer. Rapid airway compromise is the main cause of death in ATC. We report a patient with ATC who presented with a large neck mass leading to CAO with long segment tracheal and right main bronchial compression and respiratory failure. Urgent Rigid Bronchoscopy was performed for airway stabilization and patient was managed with a combination airway stenting approach...
March 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28359498/stenting-of-complex-malignant-central-airway-obstruction-guided-by-a-three-dimensional-printed-model-of-the-airways
#15
Nicolas Guibert, Benjamin Moreno, Gavin Plat, Alain Didier, Julien Mazieres, Christophe Hermant
Conversion of anatomic images into physical objects using three-dimensional printing (3DP) is changing the way surgeons anticipate selected technical challenges. We report herein a case of malignant central airway obstruction in the right main bronchus. Because stenting of the primary right carina is difficult, as it depends on many diameters and distance measurements, we used 3DP to plan and guide the procedure. After virtual resolution of the extrinsic compression, a three-dimensional printed model of the airways helped us choose the model and dimensions of the stent, and allowed us to modify its accuracy before insertion...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28349659/endoscopic-management-of-tissue-engineered-tracheal-graft-stenosis-in-an-ovine-model
#16
Victoria K Pepper, Ekene A Onwuka, Cameron A Best, Nakesha King, Eric Heuer, Jed Johnson, Christopher K Breuer, Jonathan M Grischkan, Tendy Chiang
OBJECTIVE: To evaluate the safety and efficacy of bronchoscopic interventions in the management of tissue-engineered tracheal graft (TETG) stenosis. STUDY DESIGN: Animal research study. METHODS: TETGs were constructed with seeded autologous bone marrow-derived mononuclear cells on a bioartificial graft. Eight sheep underwent tracheal resection and orthotopic implantation of this construct. Animals were monitored by bronchoscopy and fluoroscopy at 3 weeks, 6 weeks, 3 months, and 4 months...
March 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28323735/covered-balloon-expanding-stents-in-airway-stenosis
#17
Adnan Majid, Fayez Kheir, Jey Chung, Daniel Alape, Bryan Husta, Scott Oh, Erik Folch
BACKGROUND: The balloon-expanding stents are widely available but rarely described for use within the tracheobronchial tree. This report describes our experience with these stents in airway stenosis particularly as a lobar salvage therapy. METHODS: This was a retrospective review of all records in which the balloon-expanding stents were used at a tertiary medical center. Ages, sex, location of stenosis, etiology of stenosis, stent size, duration of stent placement and associated interventions for airway stenosis were recorded...
April 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28298961/transplant-pulmonary-interventions-translating-lung-transplant-interventions-to-nontransplant-patients
#18
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/28292511/thoracic-stomach-right-main-bronchus-fistula-treated-with-dual-y-shaped-covered-airway-stents
#19
Z-M Li, H-B Lu, K-W Ren, X-W Han, G Wu, D-C Jiao
AIM: To determine the efficacy of dual Y-shaped covered airway stents to treat thoracic stomach-right main bronchus fistulae. MATERIAL AND METHODS: Fifteen patients who developed thoracic stomach-right main bronchus fistula after oesophageal cancer resection and postoperative irradiation were retrospectively analysed. All fistulae were close to the right upper lobe bronchus. Two Y-shaped covered airway stents were designed for each patient. Under radiographic guidance, one stent was placed from the right main bronchus into the bifurcation of upper lobe and intermediate bronchus, the other was placed from the trachea into both main bronchi...
March 11, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28277335/voice-and-swallowing-outcomes-for-adults-undergoing-reconstructive-surgery-for-laryngotracheal-stenosis
#20
Gemma M Clunie, Andrew J Kinshuck, Gurpreet S Sandhu, Justin W G Roe
PURPOSE OF REVIEW: Adult laryngotracheal stenosis is a rare, multifactorial condition which carries a significant physical and psychosocial burden. Surgical approaches have developed in recent years, however, voice and swallowing function can be affected prior to treatment, in the immediate postoperative phase, and as an ongoing consequence of the condition and surgical intervention. In this study we discuss: the nature of the problem; surgical interventions to address airway disorders; optimal patterns of care to maximize voice and swallowing outcomes...
June 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
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