Thornton Raymond H, Gordon Roy L, Kerlan Robert K, LaBerge Jeanne M, Wilson Mark W, Wolanske Kristen A, Gotway Michael B, Hastings Geoffrey S, Golden Jeffrey A
Department of Radiology, University of California, San Francisco, San Francisco, Calif, USA.
Radiology. 2006 Jul;240(1):273-82. doi: 10.1148/radiol.2401042169.
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.
回顾性确定因良性疾病接受气管支气管支架置入术患者的长期预后。
本回顾性符合健康保险流通与责任法案（HIPAA）的研究获得机构审查委员会批准，且无需知情同意。从介入放射学数据库中识别出40例（22例女性，18例男性；平均年龄52.0岁）因良性狭窄接受金属气道支架治疗的患者。气道狭窄的原因包括移植狭窄（n = 13）、气管插管损伤（n = 10）、炎症（n = 6）、气管支气管软化（n = 4）、感染（n = 3）和外部压迫（n = 4）。随访时间为6至2473天，对死亡患者通过病历审查进行随访，对存活患者通过临床就诊或电话访谈进行随访。采用Kaplan-Meier乘积限界法估计生存率、初次通畅率和辅助通畅率。
所有病例均取得了初始技术成功。40例中有39例症状改善。复查时，15例患者存活且临床症状改善，18例死于合并症，1例死因不明，3例接受了后续气道手术，2例取出了气道支架，1例失访。1、2、3、4、5和6年的生存率分别为79%、76%、51%、47%、38%和23%。初次通畅性在第1年丧失最快。通过重复干预，6.8年时辅助通畅率为90%。
气管支气管支架通畅性在第1年丧失最快，二次干预可实现较高的长期通畅率。金属气道支架耐受性良好，是治疗某些良性气管支气管狭窄的有用辅助手段。
