Kapoor Baljendra S, May Ben, Panu Neety, Kowalik Karen, Hunter David W
Vascular & Interventional Radiology, University of Alabama at Birmingham, H623 New Hillman Building, 619 19th Street S, Birmingham, AL 35249, USA, and Royal University Hospital Saskatoon, SK, Canada.
J Vasc Interv Radiol. 2007 May;18(5):629-32. doi: 10.1016/j.jvir.2007.02.021.
To retrospectively evaluate the efficacy and complications of endobronchial stent placement for the management of airway complications following lung transplant.
From 1992 to 2003, tracheobronchial stenting was performed on 25 lung transplant recipients (16 male and 9 female; mean age 51.6 years; range 21-65 years). A total of 27 lesions were treated and 27 stents were deployed (nine bronchomalacia, 12 bronchial stenosis, three bronchial stenosis and bronchomalacia both and three anastomotic dehiscence). The clinical and bronchoscopic follow-up ranged from 1 month to 69 months.
The technical success was 100%. Eighty-four percent of patients had immediate relief in dyspnea. The overall complication rate following stent placement was 0.049 per patient per month (23 complications/471 patient months). Stent migration and granulation tissue formation were the most frequent complications. The mean percentage change in FEV-1 was significantly greater than zero at 1 month and 6 months (P<.05) post-stent placement. The mean percentage change in FEV-1 was marginally greater than zero at 12 months (P=.07).The mean percentage change in FVC was marginally greater than zero at 1 month and 6 months (P=.08) post-stent. It was not significantly greater than zero at 12 months (P=1.00).
Tracheobronchial stent placement provides effective palliation of postoperative airway complications in lung transplant with morbidity that can be managed effectively by available treatment options. Airway stenting may be used as a primary management option for airway complications after lung transplantation as a large number of patients are not suitable candidates for repeat surgery.
回顾性评估支气管内支架置入术治疗肺移植术后气道并发症的疗效及并发症。
1992年至2003年，对25例肺移植受者（男16例，女9例；平均年龄51.6岁；范围21 - 65岁）行气管支气管支架置入术。共治疗27处病变，置入27枚支架（9例支气管软化，12例支气管狭窄，3例同时存在支气管狭窄和支气管软化，3例吻合口裂开）。临床及支气管镜随访时间为1个月至69个月。
技术成功率为100%。84%的患者呼吸困难立即缓解。支架置入术后总体并发症发生率为每位患者每月0.049（23例并发症/471患者月）。支架移位和肉芽组织形成是最常见的并发症。支架置入后1个月和6个月时，第1秒用力呼气容积（FEV-1）的平均变化百分比显著大于零（P<0.05）。12个月时FEV-1的平均变化百分比略大于零（P = 0.07）。用力肺活量（FVC）在支架置入后1个月和6个月时的平均变化百分比略大于零（P = 0.08）。12个月时其变化百分比不显著大于零（P = 1.00）。
气管支气管支架置入术可有效缓解肺移植术后气道并发症，其发病率可通过现有治疗方法有效控制。气道支架置入术可作为肺移植术后气道并发症的主要治疗选择，因为大量患者不适合再次手术。
