Dedicated Bifurcated Silicone Stent Placement for Stenosis Around Primary Right Carina

Oki, Masahide; Sasaki, Hideo; Kotagawa, Chiyoe; Kogure, Yoshihito; Ryuge, Misaki; Adachi, Takashi; Oka, Saori; Tsuboi, Rie

doi:10.1378/chest.1388648

Cited by 4 publications

(8 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Airway stents should be made to fit the anatomic structures of the airway and to cover the whole lesions. Currently, no ideal stenting to cover the upper left carina or primary right carina (10) have been produced to maintain airway patency, except for silicone bifurcated stents (2,3,11–14). Because silicone stents are easily removed, durable, and of low cost, these stents are widely used in clinical settings (13,17–19).…”

Section: Discussionmentioning

confidence: 99%

“…Currently, no ideal stenting to cover the upper left carina or primary right carina (10) have been produced to maintain airway patency, except for silicone bifurcated stents (2,3,11–14). Because silicone stents are easily removed, durable, and of low cost, these stents are widely used in clinical settings (13,17–19). Conversely, metallic stents showed good support and flexibility, could be placed with the help of guide wires, resulted in less trauma, minimized the procedures needed in fistula cases (14), and could be used as an alternative to silicone bifurcated stents (14).…”

Section: Discussionmentioning

confidence: 99%

“…Because silicone stents are easily removed, durable, and of low cost, these stents are widely used in clinical settings (13,(17)(18)(19). Conversely, metallic stents showed good support and flexibility, could be placed with the help of guide wires, resulted in less trauma, minimized the procedures needed in fistula cases (14), and could be used as an alternative to silicone bifurcated stents (14).…”

Section: Discussionmentioning

confidence: 99%

“…In this retrospective study, we inserted small metallic bifurcated stents into the upper left carina to maintain airway patency of the upper and lower left bronchi. Although Dumon bifurcated stents were initially used to treat stenotic main and primary right carinas (3,11,12,16), and dedicated silicone bifurcated stents were designed to fit the primary right carina (13,18,19), the upper left carinal angle differs from that of the other angles, and more patients had bifurcated stents placed in the primary right carina compared with the upper left carina. The upper right bronchial lobe branches are at an acute angle, so inserting the bifurcated stents in the primary right carina is often complicated (3,11,12).…”

Section: Discussionmentioning

confidence: 99%

“…An ideal airway stent should be able to cover the entire lesion, with a shape selected to fit the anatomic structure of the airway. Silicone bifurcated stents have been used in the lesions of the main, primary right (3,(10)(11)(12)(13), and upper left carinas (2,14). Silicone bifurcated stents are usually inserted using the "push" or "pullback" techniques and adjusted with forceps.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

A small bifurcated self-expanding metallic stent for malignant bronchial fistula or severe stenosis around the upper left carina

et al. 2019

Acta Radiol

View full text Add to dashboard Cite

Background Bifurcated self-expanding metallic stents have mainly been primarily used for the treatment of airway disease around the main carina, but few studies have reported the use of small bifurcated stents to treat malignant bronchial fistula or severe stenosis around the upper left carina. Purpose We aimed to determine the safety, feasibility, and efficacy of small metallic bifurcated stent placement in the upper left carina. Material and Methods Twenty-two patients with malignant bronchial disease were treated with small bifurcated stents. All bifurcated stents were custom-designed according to the measurement of CT measurements and placed under local anesthesia with fluoroscopic guidance. Clinical outcomes and CT imaging data were retrospectively analyzed. Results A total of 27 stents were used in 22 patients, with two stents removed immediately after placement due to stent insufficient dilation and failure of sealing fistula. Twenty patients underwent successful treatment, with a technical success of 90.9%. Thirteen complications were found in 9 (40.9%) patients. Five patients underwent successful stent removal due to failure of sealing fistula (n = 2) or because they were effectively cured (n = 3) during the follow-up period. Ten patients died of cancer, one patient died of chronic renal failure, and one died of myocardial infarction. The one-, three-, and five-year survival rates were 48.0%, 40.0%, and 32.0%, respectively. The median survival was 12.7 months. Conclusion Small bifurcated self-expanding metallic stents are a safe and effective treatment option for malignant bronchial fistula or severe stenosis around the upper left carina, but complications are relatively high. Further prospective studies are needed to evaluate alternative treatment options.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A small bifurcated self-expanding metallic stent for malignant bronchial fistula or severe stenosis around the upper left carina

et al. 2019

Acta Radiol

View full text Add to dashboard Cite

show abstract

Long-term efficacy and safety of the Dumon stent for benign tracheal stenosis: a meta-analysis

Chen¹,

Chen²,

Zhong³

et al. 2021

J Thorac Dis

View full text Add to dashboard Cite

Background: The short-term efficacy of Dumon stent has been well demonstrated. Across years, however, due to insufficient sample size and absent of the randomized controlled trial, no reliable conclusion could be reach for Dumon stent's long-term efficacy. So, we conducted the first meta-analysis to evaluate the longterm efficacy and safety of the Dumon stent for benign tracheal stenosis.Methods: Data on related trials were obtained by doing a literature search in PubMed, Web of Science and Cochrane Library. Random-effect and fixed-effect models were used to calculate the efficacy and incidence of complication of Dumon stent placement. Results: A total of 395 patients from 8 studies were included in this study, revealing that the stability rate was 41.12% (95% CI, 34.85-48.52%) of Dumon stenting. Further, a curative rate of 40.74% (95% CI, 34.92-47.53%), and efficacy of 75.49% (95% CI, 70.89-80.39%) were obtained from this study. Analysis of the incidence of complications indicated 25.04% of migration (95% CI, 17.52-35.79%), 15.66% granulation (95% CI, 9.39-26.11%) and 23.82% of mucus retention 23.82% (95% CI, 13.77-41.20%).Conclusions: Dumon stent has a moderate efficacy for treating benign tracheal stenosis with approximately 20% incidence of complication, regular bronchoscopy follow-up should be conducted. Thus, further research is required to modified Dumon stenting.

show abstract

Techniques of endoscopic airway tumor treatment

Guibert¹,

Mhanna²,

Droneau³

et al. 2016

J. Thorac. Dis.

View full text Add to dashboard Cite

Interventional bronchoscopy has a predominant role in the management of both early and advanced-stage airway tumors. Given the very poor prognosis of lung cancer, there is a need for new tools to improve early detection and bronchoscopic treatment of endo-bronchial precancerous lesions. In more advanced stages, interventional bronchoscopy plays an important role, as nearly a third of lung cancers lead to proximal airway obstruction. This will cause great discomfort or even life-threatening symptoms related to local extension, such as dyspnea, post-obstructive pneumonia, and hemoptysis. Surgery for very locally advanced disease is only effective for a limited number of patients and the effects of conventional antitumor therapies, like radiation therapy or chemotherapy, are inconstant and are too delayed in a palliative context. In this review, we aim to provide pulmonologists with an exhaustive technical overview of (I) the bronchoscopic management of benign endobronchial lesions; (II) the bronchoscopic management of malignant tumors, including the curative treatment of localized lesions and palliative management of malignant proximal airway stenosis; and (III) descriptions of the emerging endoscopic techniques used to treat peripheral lung tumors.

show abstract

Dedicated Bifurcated Silicone Stent Placement for Stenosis Around Primary Right Carina

Cited by 4 publications

References 0 publications

A small bifurcated self-expanding metallic stent for malignant bronchial fistula or severe stenosis around the upper left carina

A small bifurcated self-expanding metallic stent for malignant bronchial fistula or severe stenosis around the upper left carina

Long-term efficacy and safety of the Dumon stent for benign tracheal stenosis: a meta-analysis

Techniques of endoscopic airway tumor treatment

Contact Info

Product

Resources

About