Chhajed Prashant N, Malouf Monique A, Tamm Michael, Glanville Allan R
The Lung Transplant Unit, St. Vincent's Hospital, Sydney, New South Wales, Australia.
Respirology. 2003 Mar;8(1):59-64. doi: 10.1046/j.1440-1843.2003.00425.x.
We present our experience with the use of the Ultraflex (nitinol) stents in the management of airway complications in lung transplant (LT) recipients.
Nine LT recipients underwent insertion of uncovered Ultraflex stents. Mean change in FEV1, duration to formation of granulation tissue and follow-up post-stent insertion were compared with results obtained in LT recipients who had undergone Gianturco stent (n = 10) and Wallstent insertion (n = 16).
Mean improvement in FEV1 after insertion of Gianturco, Wallstent and Ultraflex stents was 670 +/- 591 mL, 613 +/- 221 mL and 522 +/- 391 mL, respectively. No patient with an Ultraflex stent developed mucus plugging or stenosis at stent extremity at a follow up of 263 +/- 278 days. The mean and median duration to stenosis at stent extremity for patients with Gianturco stents was 102 +/- 85 days and 73 days, respectively, compared with 132 +/- 87 days and 142 days, respectively, for patients with Wallstents. Stricture formation in the middle of the Ultraflex stent occurred bilaterally, at the level of anastomosis in one patient in whom stent placement was undertaken in the presence of inflammation. Stent migration in one patient was related to undersizing of the stent diameter relative to the airway diameter. A larger diameter relative stent was subsequently inserted successfully.
Ultraflex stents appear to have fewer long-term complications when used in the management of airway complications following LT.
我们介绍使用Ultraflex（镍钛合金）支架治疗肺移植（LT）受者气道并发症的经验。
9例LT受者接受了裸Ultraflex支架植入。将第1秒用力呼气容积（FEV1）的平均变化、肉芽组织形成时间以及支架植入后的随访情况与接受Gianturco支架植入（n = 10）和Wallstent植入（n = 16）的LT受者的结果进行比较。
植入Gianturco支架、Wallstent支架和Ultraflex支架后，FEV1的平均改善分别为670±591 mL、613±221 mL和522±391 mL。在263±278天的随访中，没有使用Ultraflex支架的患者出现黏液堵塞或支架末端狭窄。Gianturco支架患者支架末端狭窄的平均和中位时间分别为102±85天和73天，而Wallstent支架患者分别为132±87天和142天。Ultraflex支架中部的狭窄在双侧出现，在1例因炎症而植入支架的患者中，狭窄发生在吻合口水平。1例患者的支架迁移与支架直径相对于气道直径过小有关。随后成功插入了一个直径更大的相关支架。
在LT后气道并发症的治疗中，使用Ultraflex支架似乎长期并发症较少。
