Endobronchial metallic stent placement for airway complications after lung transplantation

Burns, Karen E. A.; Orons, Philip D.; Dauber, James H.; Grgurich, Wayne F.; Stitt, Larry; Raghu, Sujatha; Iacono, Aldo

doi:10.1016/s0003-4975(02)04033-x

Cited by 39 publications

(45 citation statements)

References 10 publications

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“…Clinical improvement rates and other observed complication rates (mucus plugging, migration and haemoptysis) were comparable to other studies using Ultraflex1 stents [9,[16][17][18]21].…”

Section: Discussionsupporting

confidence: 85%

“…Our re-stenosis rate was 52%, which is higher than in other studies reporting a re-stenosis rate of 10-47% [9,17,18,20,21]. This may be due to our longer follow-up period, given that restenosis occurred up to 2 yrs after insertion and that we used mainly noncovered stents.…”

Section: Discussioncontrasting

confidence: 69%

“…To our knowledge, five small case series involving up to 33 patients have been published on the exclusive use of SEMS in lung transplant recipients [7,[20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

“…Recently published case reports with Ultraflex1 stents in lung transplant patients [20][21][22] included seven to 30 patients with a follow-up duration between 263 and 400 days, compared with 777 days in our study. Our first patient fitted with an Ultraflex1 stent is still alive, .10 yrs after insertion and bronchoscopy performed 3.547 days after insertion revealed a patent stent lumen.…”

Section: Discussionmentioning

confidence: 99%

“…BURNS et al [21] studied colonisation in lung transplant patients with SEMS and demonstrated that 56% of BAL specimens were positive. Recent studies have shown that Pseudomonas colonisation of the allograft was associated with a higher risk for BOS.…”

Section: Discussionmentioning

confidence: 99%

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Are metallic stents really safe? A long-term analysis in lung transplant recipients

Gottlieb¹,

Fuehner²,

Dierich³

et al. 2009

European Respiratory Journal

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Airway complications affect 20% of all lung transplant recipients. Self-expandable metallic stents (SEMS) are one treatment option but their use in benign airway disorders is controversial. We studies the long-term safety of SEMS in lung transplant recipients.Between January 1998 and February 2008, all lung transplant recipients with SEMS were analysed retrospectively at a single centre. Complications were recorded until September 2008. In 65 (9.2%) out of 706 recipients, 111 (91% noncovered) bronchial SEMS were implanted a median (range) 133 (55-903) days after lung transplantation; follow-up was 777 (7-3.655) days. Clinical improvement was noted in 80% of recipients. The forced expiratory volume in 1 s increased by (mean¡SD) 21¡33%.Most frequent early complications were migration (3%) and mucus plugging (11%). No procedure-related deaths were noted. Re-stenosis occurred in 34 (52%) out of 65 recipients 85 (7-629) days after insertion. In multivariate analysis, stent insertion before post-operative day 90 was independently associated with an increased risk of re-stenosis (HR 3.29, 95% CI 1.50-7.18; p50.003). In 40% of recipients, new bacterial airway colonisation occurred after SEMS insertion. In SEMS patients, 5-yr survival was significantly lower than in the total cohort (60% versus 76%; p50.02).Late complications in lung transplant recipients treated with SEMS are frequent. The major problems are re-stenosis and airway colonisation.

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“…Clinical improvement rates and other observed complication rates (mucus plugging, migration and haemoptysis) were comparable to other studies using Ultraflex1 stents [9,[16][17][18]21].…”

Section: Discussionsupporting

confidence: 85%

Section: Discussioncontrasting

confidence: 69%

“…To our knowledge, five small case series involving up to 33 patients have been published on the exclusive use of SEMS in lung transplant recipients [7,[20][21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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