Kim Jin Hyoung, Shin Ji Hoon, Song Ho-Young, Lee Se Chul, Kim Kyung Rae, Park Jung-Hoon
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea.
J Vasc Interv Radiol. 2008 Aug;19(8):1208-14. doi: 10.1016/j.jvir.2008.05.004. Epub 2008 Jun 27.
The authors hypothesized that internally covered stents can reduce the rates of stent migration or mucous retention. The authors performed this study to report their experience with use of a retrievable metallic stent internally coated with silicone in patients with benign or malignant central airway obstructions.
From 2004 to 2007, the authors performed fluoroscopically guided placement of a retrievable metallic stent internally coated with silicone in 26 consecutive patients with benign (n = 5) and malignant (n = 21) central airway obstructions. Stents were woven from a single thread of a 0.2-mm-diameter nitinol wire in a tubular configuration and internally covered with silicone membrane.
Stent placement was technically and clinically successful in 93% (25/26) and 85% (22/26) of the patients, respectively. There were eight complications (31%) after stent placement, including tumor overgrowth (n = 2), stent migration (n = 1), symptomatic granulation tissue formation (n = 1), severe pain (n = 1), improper stent location (n = 1), symptomatic sputum retention (n = 1) and esophagobronchial fistula (n = 1). Because of complications, five stents were removed with a retrieval hook under fluoroscopic guidance without difficulty. The median survival period and stent patency were 150.0 days +/- 91.4 and 143.0 days +/- 26.7, respectively.
The use of a retrievable metallic stent internally coated with silicone is a safe and effective method for relieving dyspnea, with adequate stent patency in patients with benign or malignant central airway obstructions. This stent design seems to be less prone to migration or mucous retention.
作者推测内置覆膜支架可降低支架移位或黏液潴留的发生率。作者开展本研究以报告其在良性或恶性中央气道梗阻患者中使用可回收硅酮涂层金属支架的经验。
2004年至2007年,作者对26例连续的良性(n = 5)和恶性(n = 21)中央气道梗阻患者进行了荧光透视引导下的可回收硅酮涂层金属支架置入术。支架由一根直径0.2毫米的镍钛诺丝编织成管状结构,并在内部覆盖硅酮膜。
支架置入在技术上和临床上分别成功应用于93%(25/26)和85%(22/26)的患者。支架置入后出现8例并发症(31%),包括肿瘤过度生长(n = 2)、支架移位(n = 1)、有症状的肉芽组织形成(n = 1)、严重疼痛(n = 1)、支架位置不当(n = 1)、有症状的痰液潴留(n = 1)和食管支气管瘘(n = 1)。由于并发症,5个支架在荧光透视引导下用回收钩顺利取出。中位生存期和支架通畅时间分别为150.0天±91.4天和143.0天±26.7天。
使用可回收硅酮涂层金属支架是缓解呼吸困难的一种安全有效的方法,在良性或恶性中央气道梗阻患者中具有足够的支架通畅性。这种支架设计似乎不太容易发生移位或黏液潴留。