Outcomes of Tracheobronchial Stent Placement for Benign Disease 1

Department of Radiology, University of California, San Francisco, San Francisco, Calif, USA.
Radiology (Impact Factor: 6.87). 08/2006; 240(1):273-82. DOI: 10.1148/radiol.2401042169
Source: PubMed


To retrospectively determine long-term outcomes in patients who have undergone tracheobronchial stent placement for benign diseases.
Institutional Review Board approval was obtained for this retrospective HIPAA-compliant study, with waiver of informed consent. Forty patients (22 female, 18 male; mean age, 52.0 years) who were treated with metallic airway stents for benign stenosis were identified from an interventional radiology database. Causes of airway stenosis included transplant stricture (n = 13), tracheal tube injury (n = 10), inflammation (n = 6), tracheobronchomalacia (n = 4), infection (n = 3), and extrinsic compression (n = 4). Follow-up, which ranged from 6 to 2473 days, was performed by means of chart review for deceased patients and by means of clinical visit or telephone interview for surviving patients. Survival, primary patency, and assisted patency were estimated by using the Kaplan-Meier product limits method.
Initial technical success was achieved in all cases. Symptomatic improvement was present in 39 of 40 cases. At review, 15 patients were alive and had clinical improvement, 18 had died of comorbid causes, one had died of uncertain causes, three had undergone subsequent airway surgery, two had undergone airway stent retrieval, and one was lost to follow-up. Survival at 1, 2, 3, 4, 5, and 6 years was 79%, 76%, 51%, 47%, 38%, and 23%, respectively. Loss of primary patency was most rapid during the 1st year. With repeat intervention, assisted patency was 90% at 6.8 years.
Attrition of tracheobronchial stent patency is most rapid during the 1st year, and a high rate of long-term patency can be achieved with secondary interventions. Metallic airway stents are well-tolerated and useful adjuncts for management of select benign tracheobronchial stenoses.

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    • "Softening may occur in part or all of the tracheal cartilage and may even extend beyond the trachea (tracheobronchomalacia). Methods for the treatment of severe tracheomalacia in adults are limited and there is no uniform standard. Surgical treatments, including stent implantation (2,3), tracheostomy tube insertion (1) and external tracheal stabilization (4), have been shown to have a number of therapeutic effects; however, their use requires careful consideration on an individual basis and is generally restricted to patients with localized disease. With regards to medical treatments, the efficacy of corticosteroids in tracheomalacia has not been scientifically proven and the use of continuous positive airway pressure (CPAP) in tracheomalacia is rarely reported (5,6). "
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