Placement of integrated self-expanding Y-shaped airway stent in management of carinal stenosis

Ye, Qiao; Fu, Yu‐Fei; Cheng, Long; Niu, Su; Cao, Chao

doi:10.1007/s11547-016-0653-2

Cited by 11 publications

(14 citation statements)

References 14 publications

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“…Survival has been reported to be 109-181 days with a Y-type silicon stent and 116-217 days with Y-shaped SEMS. 17,[25][26][27][28][29] In our study, survival in the silicon and SEMS groups were 164.51 ± 38.83 days and 254.45 ± 103.32 days, respectively (P > .05).…”

Section: Discussionmentioning

confidence: 81%

“…Many retrospective studies have considered the survival effects of airway stent applications. Survival has been reported to be 109‐181 days with a Y‐type silicon stent and 116‐217 days with Y‐shaped SEMS . In our study, survival in the silicon and SEMS groups were 164.51 ± 38.83 days and 254.45 ± 103.32 days, respectively ( P > .05).…”

Section: Discussionmentioning

confidence: 99%

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Comparison of silicon and metallic bifurcated stents in patients with malignant airway lesions

Sökücü

Özdemir

Önür

et al. 2019

Clinical Respiratory J

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Introduction and objective Silicon and metallic are two types of stents in use. In this study, we compared complications and long‐term survival among patients who received silicon or fully covered, bifurcated self‐expandable metallic stents (SEMS) for a malignant tracheobronchial obstruction and/or tracheo/bronchial oesophageal fistulas. Methods Patients in whom Y‐shaped stents were used from January 2013 to June 2017 in our interventional pulmonology unit were evaluated retrospectively from patient files. Results Of the 47 patients, 30 (23 males, 76.7%) were in the silicon stent group and 17 (14 males, 82.4%) were in the covered SEMS group. No differences between the groups were detected in ECOG status, pathological properties of the disease, radiotherapy or chemotherapy history before the procedure, symptoms at presentation, or comorbidities. The most common symptom was dyspnoea (96.7% and 100%), and the most common comorbidity was chronic obstructive pulmonary disease (26.7% and 23.5%). A total of 20 complications (42.6%) were seen, with no significant difference between the groups (silicon, 40%; SEMS, 47.1%; P = . 62). Mean survival was 164.51 ± 38.83 days for the silicon stent group and 254.45 ± 103.32 days for the SEMS group (P = .588). No differences were observed in 30‐, 90‐ or 180‐day mortality between the two groups (P = .966, .846 and .534, respectively). Conclusions No significant differences in symptom palliation, insertion safety, complication rate or survival were detected between the two types of stent.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Comparison of silicon and metallic bifurcated stents in patients with malignant airway lesions

Sökücü

Özdemir

Önür

et al. 2019

Clinical Respiratory J

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“…At present, treatments for malignant carinal stenosis are challenging (14)(15)(16). Various malignances can occur in the carinal region including the lower trachea and the proximal end of the bilateral main bronchus (1).…”

Section: Discussionmentioning

confidence: 99%

“…Once deployed, they can interfere with mucociliary clearance, resulting in secretion retention (23). Compared to silicone stents, self-expanding Y-shaped metal stents are relatively easy to insert and have improved expansion force (16). Following insertion, they can gradually expand to a predetermined shape that matches the contour of the tracheobronchial tree and requires less routing care (8).…”

Section: Discussionmentioning

confidence: 99%

Application of Micro‑Tech stents in malignant carinal stenosis

et al. 2019

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Malignant carinal stenosis is a disease process that is not always suitable for treatment with a Y-shaped stent. When one of the main bronchi is completely obstructed and cannot be recanalized, or its distal lung tissue has lost function, inserting a Y-shaped stent is infeasible. In this complex condition, a cone-shaped stent is selected to maintain the patency of the trachea and the other main bronchus. The efficacy of the bare cone-shaped Micro-Tech stent to treat malignant carinal stenosis was evaluated in the current study. The medical records of 47 patients with malignant carinal stenosis who underwent Micro-Tech stent placement between January 2004 and October 2017 in Beijing Tian Tan Hospital (Beijing, China) were analyzed retrospectively. A total of 47 bare Micro-Tech stents (28 Y-shaped and 19 cone-shaped) were successfully inserted in the patients. Following stent placement, immediate satisfactory results were achieved in all patients, especially an improvement of dyspnea (100%), cough (81.1%) and stridor (100%). The Karnofsky scores were significantly increased (P<0.001), and the American Thoracic Society Dyspnea Index values were significantly decreased (P<0.001). Following a median of 88 days, initial bronchoscopic interventions were performed for tumor overgrowth (84.6%), stent fracture (7.7%) and granulation tissue (7.7%). Restenting was performed in two patients due to tumor progression (n=1) and stent fracture (n=1). Removal of a Y-shaped stent was attempted in one patient, but failed, as the stent had become partly embedded in the airway mucosa. In conclusion, cone-shaped Micro-Tech stent placement maintained tracheal-unilateral main bronchus patency and benefitted patients with malignant carinal stenosis in whom Y-shaped stents were not suitable for insertion.

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“…The choice remains for the treating physician to choose which to use. Furthermore, stents can be introduced using a variety of techniques under general or mild anesthesia, the choice based on the treating physicians’ experience, medical underlying disease, and the centers’ available equipment 7,8. Regarding patients with malignancy, some prognostic factors such as stridor and postprocedure chemotherapy have been identified as independent prognostic factors 6,9.…”

Section: Introductionmentioning

confidence: 99%

A retrograde y-stenting of the trachea for treatment of mediastinal fistula in an unusual situation

Hohenforst-Schmidt¹,

Steinheimer²,

Schneider³

et al. 2017

TCRM

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IntroductionStents 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 methodsIn 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. The patient was diagnosed with a papillary thyroid carcinoma in 1989, which was treated by resection and radiotherapy. In the following years, she developed a stenosis of the esophagus. The decision to try endobronchial stenting was made upon the plan to close that fistula with a pedicled omentum majus replacement through the diaphragmal opening of the esophagus. This surgical plastic needed an abutment and a secured continuous airway replacement above the tracheostoma level. A Freitag stent (FS), 11 cm in length (110–25–40) and an inner diameter of 13 mm, was placed successfully retrograde into the trachea and completely bridged the big fistula. Unfortunately the patient passed away due to pulmonary infections after several weeks.DiscussionIn this case report, a successful but unusual case of retrograde stent placement of a modified FS is presented.

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Placement of integrated self-expanding Y-shaped airway stent in management of carinal stenosis

Abstract: Placement of integrated self-expanding Y-shaped airway stent is a simple, safe, and effective method for patients with carinal stenosis.

Cited by 11 publications

References 14 publications

Comparison of silicon and metallic bifurcated stents in patients with malignant airway lesions

Comparison of silicon and metallic bifurcated stents in patients with malignant airway lesions

Application of Micro‑Tech stents in malignant carinal stenosis

A retrograde y-stenting of the trachea for treatment of mediastinal fistula in an unusual situation

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