Nakajima Y, Kurihara Y, Niimi H, Konno S, Ishikawa T, Osada H, Kojima H
Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, 216-8511 Japan.
Cardiovasc Intervent Radiol. 1999 Jul-Aug;22(4):287-92. doi: 10.1007/s002709900390.
To describe our experience using the Gianturco Z-stent (G-Z stent) for the management of malignant tracheobronchial stenosis, with special reference to complications.
Thirty-six stents were used in 22 patients with 28 lesions. Thirteen patients were grade 5 according to the Hugh-Jones classification. The technical success rates, follow-up results, and complications were reviewed on the basis of the patients' charts and radiographs.
All stents were successfully placed in the ideal position without procedure-related complications. After the procedure, respiratory status improved in 95% (21/22) of patients, and performance status improved in 77% (17/22). Mean survival after stent placement was 15 weeks. Four patients suffered from increased thick secretions requiring multiple suctioning and aspiration by bronchoscopy. One of these patients died from asphyxiation 2 weeks after placement. Stent disruption and/or migration was observed in six patients. Of these six, four experienced life-threatening hemoptysis; all four had received aggressive anticancer treatment.
G-Z stents are useful for palliation of malignant tracheobronchial obstruction. However, complications of stent strut fracture and migration give cause for concern.
描述我们使用Gianturco Z形支架（G-Z支架）治疗恶性气管支气管狭窄的经验，特别提及并发症。
22例患者的28处病变使用了36个支架。根据Hugh-Jones分类，13例患者为5级。根据患者病历和X光片回顾技术成功率、随访结果及并发症情况。
所有支架均成功放置于理想位置，无手术相关并发症。术后，95%（21/22）的患者呼吸状况改善，77%（17/22）的患者功能状态改善。支架置入后的平均生存期为15周。4例患者出现分泌物增多，需要多次通过支气管镜吸引。其中1例患者在置入后2周死于窒息。6例患者观察到支架断裂和/或移位。在这6例中，4例发生危及生命的咯血；这4例均接受了积极的抗癌治疗。
G-Z支架可有效缓解恶性气管支气管梗阻。然而，支架支柱断裂和移位的并发症令人担忧。
