Successful Bronchoscopic Placement of Tracheobronchial Stents Without Fluoroscopy

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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“…Stent insertion was performed by flexible bronchoscopy under general anaesthetic or with moderate sedation, as previously described [12].…”

Section: Methodsmentioning

confidence: 99%

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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“…Previously in a study by Herth et al the authors placed plain metallic stents in 96 patients using fiberoptic bronchoscopy with guidewire guidance, where fluoroscopy was not employed. In this study no procedure-related complication was noted (13). In a study by Lin et al the authors used fiberoptic bronchoscopy with guidewire guidance to treat airway lesions, where fluoroscopy was not used.…”

Section: Discussionmentioning

confidence: 61%

“…Moreover; the treating physician will choose the method of application based on the general clinical condition of the patient, the experience of the team and the capacity of the treating unit. Currently there are guidelines for the use of either guidewires alone or guidewires with the combination of fluoroscopy (12,13). There is also a study where rigid bronchoscopy, as used without the need for either fluoroscopy or guidewires (14).…”

Section: Introductionmentioning

confidence: 99%

Obstruction of the right stem bronchus due to ovarian local metastasis: a 5-year follow-up

Karapantzos¹,

Karanikas²,

Thomaidis

et al. 2016

Ann. Transl. Med.

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Currently interventional bronchoscopy is used for debulking, desobstruction and airway patency stabilization. The interventional techniques are being used for both benign and malignant cases. There are two types of stents that are currently being used, silicon and self-expandable metallic. The method of application and stent remains for the treating physician to choose. In the current case we will present a case of metastatic disease from ovarian cancer in the airway lumen and a long term follow-up.

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“…In rascher Folge wurde dann von vielen Autoren, zum Teil an sehr kleinen Fallzahlen, über weitere Erfahrungen mit der Einlage von Metall-Endoprothesen berichtet, wie sie schon seit längerem in der Angiologie zur Anwendung kamen. [17,18].…”

Section: Historieunclassified

Endobronchiales Stenting

2007

Schweiz Ärzteztg

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Successful Bronchoscopic Placement of Tracheobronchial Stents Without Fluoroscopy

Cited by 57 publications

References 3 publications

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

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

Obstruction of the right stem bronchus due to ovarian local metastasis: a 5-year follow-up

Endobronchiales Stenting

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