Removal of covered metallic stents with a bullet head for bronchopleural fistula using a fluoroscopy-assisted interventional technique

Xie, Pengfei; Yin, Meipan; Zhao, Yue; Liu, Y.; Qi, Yu; Li, X.-N.; Li, C.-X.; Wu, Gang

doi:10.1016/j.crad.2020.07.034

Cited by 6 publications

(5 citation statements)

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“…Tracheal metal stents are categorized as covered, partially covered, and uncovered. Stent restenosis, stent displacement, and stent rupture after granulation tissue formation are possible complications after tracheal metal stent implantation [ 4 , 12 ]. Prolonged indwelling of tracheal stents may increase the risk of complications.…”

Section: Discussionmentioning

confidence: 99%

“…This technique requires general anesthesia, and when the tracheal wall is too close to the stent, stent removal with a rigid bronchoscope is associated with the risk of mucosal bleeding. In contrast, removal of metal tracheal stents under fluoroscopic guidance does not require general anesthesia, and the damage to tracheal tissue is less than that under traditional endoscopy [ 4 ]. Over the past 15 years, 148 tracheal stents have been removed under fluoroscopy, and the success rate of complete removal of stents is 95.9% (129/135), which is much higher than the 27% success rate for complete removal of stents reported by Lunn et al Moreover, this technique is associated with fewer complications, and it does not require destruction of the whole stent, resulting in fewer stent residues [ 7 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Tracheal stent implantation is widely used in the treatment of benign and malignant tracheal stenosis or fistula [ 1 – 4 ]. Tubular airway metal stents are widely used in the clinical treatment of upper and middle tracheal stenosis or fistula, and have shown obvious therapeutic effects [ 4 ]. Long-term placement of tracheal stents can cause granulation tissue proliferation, resulting in tracheal restenosis, irritating cough, infection, bleeding, stent rupture or displacement, and other complications [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, these techniques are associated with low success rates and many complications [ 7 , 8 ]. Small-sample cases of tracheal stent removal under fluoroscopy have also been reporte [ 4 , 9 ]. The aim of this study was to assess the feasibility and safety of tracheal stent removal by an interventional technique under fluoroscopy.…”

Section: Introductionmentioning

confidence: 99%

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The strategy of removing tracheal stents by using an interventional technique under fluoroscopy

Xie

Wang

et al. 2022

BMC Pulm Med

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Background Tracheal stent implantation is widely used in clinic settings. Timely removal of tracheal stents could prevent or reduce related complications. This study was aimed at evaluating the feasibility and safety of removing tracheal stents by an interventional technique under fluoroscopy. Methods Clinical data of patients with self-expanding uncovered tracheal stents removed by an interventional technique under fluoroscopy were analyzed retrospectively, including medical records, imaging findings, surgical records, and follow-up results. According to the type and time of stent placement and the proliferation of granulation tissue under bronchoscopy, different tracheal stent removal techniques were used to remove the tracheal stent under fluoroscopy, and the feasibility and safety of the interventions were analyzed. Results In all, 148 tracheal stents were removed from 112 patients; 95.9% (142/148) of the stents were completely removed and 4.1% (6/148) had a small amount of metal residue, and foreign-body forceps were removed under fiber bronchoscopy guidance. In 78 (69.6%), 32 (21.6%), and 6 (5.4%) patients, the tracheal stent was removed by the internal stripping, direct removal, and stent-in-stent methods, respectively. The overall stent removal time ranged from 11 to 111 (28.9 ± 20.1) min. During stent removal, 16 (14.3%) and 13 (11.6%) patients developed mild and moderate complications, respectively. There were no serious complications such as massive hemorrhage, mediastinal fistula, or death. Conclusions An interventional technique under fluoroscopy for stent removal is a feasible, safe, and effective method and could serve as a technique for tracheal stent removal in clinical settings.

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Section: Discussionmentioning

confidence: 99%