Hu H-C, Liu Y-H, Wu Y-C, Hsieh M-J, Chao Y-K, Wu C-Y, Ko P-J, Liu C-Y
Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, Province of China.
Thorac Cardiovasc Surg. 2011 Apr;59(3):163-8. doi: 10.1055/s-0030-1250667. Epub 2011 Apr 8.
The present study aimed to determine whether stent diameter influences granulation tissue formation following stent placement for major airway stenosis.
Forty-two stent procedures (32 tracheal stents, 3 carinal stents, and 7 bronchial stents) were performed in 40 patients. Seventy-nine stent edge regions (62 tracheal, 17 bronchial stents) were evaluated in this study.
Granulation tissue formation was encountered in 11 patients (28.21%). Of the 34 upper ends of evaluated tracheal stents, granulation tissue formation was observed in 6 (17.65%), whereas granulation tissue formation was observed in 2 (7.14%) of the 28 lower ends of tracheal stents evaluated. Of the 17 bronchial stent edge regions, granulation tissue formation occurred in 3 (17.65%) ( P = 0.4352). The rate of granulation tissue formation was higher in those patients with a stent-to-airway diameter ratio of > 90% ( P < 0.0001). Receiver operating characteristic curve analysis further demonstrated that a cut-off stent-to-airway diameter ratio of 90% was effective in predicting granulation tissue formation (AUC: 0.897, Std. error = 0.036, P < 0.0001, 95% CI = 0827-0.968, n = 79).
A stent-to-airway diameter ratio of 90% was found to be the critical cut-off point for predicting granulation tissue formation. Therefore, the optimal stent-to-airway diameter ratio should be ascertained before stent placement.
本研究旨在确定支架直径是否会影响大气道狭窄支架置入术后肉芽组织的形成。
对40例患者实施了42次支架置入手术(32次气管支架置入、3次隆突支架置入和7次支气管支架置入)。本研究评估了79个支架边缘区域(62个气管支架、17个支气管支架)。
11例患者(28.21%)出现肉芽组织形成。在所评估的34个气管支架上端中,6个(17.65%)观察到肉芽组织形成,而在所评估的28个气管支架下端中,2个(7.14%)观察到肉芽组织形成。在17个支气管支架边缘区域中,3个(17.65%)出现肉芽组织形成(P = 0.4352)。支架与气道直径比> 90%的患者中肉芽组织形成率更高(P < 0.0001)。受试者工作特征曲线分析进一步表明,支架与气道直径比为90%的临界值可有效预测肉芽组织形成(AUC:0.897,标准误 = 0.036,P < 0.0001,95% CI = 0.827 - 0.968,n = 79)。
发现支架与气道直径比为90%是预测肉芽组织形成的关键临界点。因此,在支架置入前应确定最佳的支架与气道直径比。