Tuberculous bronchial stenosis: treatment with balloon bronchoplasty.

Nakamura, Kouichi; Terada, Norihiko; Ohi, Masaki; Matsushita, Tomomich; Kato, Naoki; Nakagawa, Takumi

doi:10.2214/ajr.157.6.1950862

Cited by 37 publications

(13 citation statements)

References 3 publications

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“…The discussed method of evaluating TBS non-invasively allows anatomical location of the lesion prior to performance of the procedure, allowing for correct choice of balloon size. Previously, evaluation of the dimensions of TBS in adults was determined either by fl uoroscopy in conjunction with bronchoscopy [2,14] , bronchoscopic appearance in conjunction with standard chest CT [8] or by using bronchography [1,5] . Standard CT scan will allow identifi cation of the lesion, but an accurate estimation of the degree and length of stenosis may not be fully appreciated using standard-sized 3-mm cuts.…”

Section: Discussionmentioning

confidence: 99%

“…Common benign causes include sarcoidosis, tuberculosis and Wegener's granulomatosis (WG) [1][2][3] . Malignant TBS may occur due to primary endo-bronchial carcinoma or metastatic disease [4,5] .…”

Section: Introductionmentioning

confidence: 99%

“…TBS can arise after prolonged endotracheal intubation, after sleeve resection or after lung transplant [6][7][8] . Balloon dilatation (BD) using fl exible fi beroptic bronchoscopy was originally described by Nakamura et al [1] and has been used as a defi nitive treatment for benign TBS or as an adjunctive method in placing endobronchial stents or brachytherapy catheters in TBS from a malignant cause [3,5,[7][8][9] . Typical preoperative evaluations to determine site and dimensions of stenosis used in these studies described above include standard computed tomography (CT) evaluation, endoscopic appearance, bronchography and fl uoroscopy.…”

Section: Introductionmentioning

confidence: 99%

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Use of 3-Dimensional Computed Tomography Reconstruction Studies in the Preoperative Assessment of Patients Undergoing Balloon Dilatation for Tracheobronchial Stenosis

Rooney

Ferguson²,

Barnhart³

et al. 2005

Respiration

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Background: Balloon dilatation (BD) is a useful method of treating tracheobronchial stenosis (TBS); however, accurate preoperative identification of the lesion is difficult. Three-dimensional computed tomography (3D-CT) is an imaging method that may allow more accurate definition of the lesion(s) preoperatively. Study Objective: It is the aim of this study to present our finding using 3D-CT as a part of the preoperative evaluation of patients with TBS undergoing BD. Methods: We studied a prospective case series of 17 consecutive patients who underwent 29 BDs for TBS from a variety of benign and malignant causes at a tertiary care hospital. All patients had a preoperative spiral CT; these data were processed by a software program, VIDA, which was developed at this institution, and 3D-CT reconstruction images of the TBS were created. This enabled accurate preoperative anatomic definition of the lesion. The patients subsequently underwent BD. Results: All 17 patients had lesions identified with 3D-CT. Six patients had tracheal lesions and 12 patients had main stem lesions. One patient had combined tracheal and main stem lesions and 2 other patients had bilateral main stem lesions. Nine out of 17 patients required only one BD. One patient had a failed BD. The remaining 6 patients required more than one BD for optimal results (up to a maximum of 4). The follow-up period ranged from 1 to 34 months. Conclusions: 3D-CT offers accurate definition of TBS, including anatomic location, number of lesions present and status of airway distal to lesion. In this study, all preoperative lesions were correctly identified prior to BD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of 3-Dimensional Computed Tomography Reconstruction Studies in the Preoperative Assessment of Patients Undergoing Balloon Dilatation for Tracheobronchial Stenosis

Rooney

Ferguson²,

Barnhart³

et al. 2005

Respiration

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“…These methods use an angioplastic balloon catheter, valvuloplasty catheters, or Fogarty catheter inserted via either a flexible or rigid bronchoscope under local or general anesthesia [1,3,7,8,10,14,18]. These procedures, however, can only be used for a limited time, because they all require an occlusive balloon.…”

Section: Discussionmentioning

confidence: 99%

Bougienage and balloon dilation using a conventional tracheal tube for tracheobronchial stenosis before stent placement

Horio

Suemasu

2000

Surg Endosc

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In order to achieve urgent restoration of the airways in tracheobronchial stenosis and to make stent placement simpler and safer, we developed a method that allows combined bougienage and balloon dilation via the use of a conventional tracheal tube. Fifteen patients with tracheobronchial stenosis underwent bougienage and balloon dilation using a tracheal tube with a cuff attached, inserted via a tracheostomy, before stent placement. The conventional tracheal tube was inserted via a tracheostomy, the cuff was expanded at the stenotic site, and the tube was fixed to the tracheostomy and left in place for a few days until sufficient dilation was achieved. This procedure was conducted on the trachea in 10 patients, the left main bronchus in three patients, and the right main bronchus in two patients. In all patients, the procedure immediately relieved the obstructive symptoms and dilated the stenosis sufficiently. Thereafter, Dumon stents were inserted in 10 patients, dynamic stents in four patients, and an expandable metallic stent in one patient. The stents were introduced easily with no other dilation procedure after a mean of 5 days from the start of the procedure. For tracheobronchial stenosis, bougienage and balloon dilation using a tracheal tube with an integral cuff via a tracheostomy is a simple and safe method for achieving both urgent relief of airway stenosis and dilation before stent placement.

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“…The following year Carlin et al (Carlin et al, 1988) reported two cases of bronchial stenosis successfully treated with a combination of bronchoscopic balloon dilation and Nd-YAG laser photoresection with a rigid bronchoscope. In 1991, balloon dilation using flexible bronchoscopy was described for the first time by Nakamura et al (Nakamura et al, 1991). They treated two patients with tuberculous bronchial stenosis through a flexible bronchoscope under local anesthesia.…”

Section: Introductionmentioning

confidence: 99%