定制带铰链覆膜金属支架治疗良性主支气管狭窄

Customized Hinged Covered Metallic Stents for the Treatment of Benign Main Bronchial Stenosis.

作者信息

Han Xinwei, Al-Tariq Quazi, Zhao Yanle, Li Lei, Cheng Zhe, Wang Huaqi, Liu Chao, Jiao Dechao, Wu Gang

机构信息

Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Department of Radiology, Pomona Valley Hospital Medical Center, Pomona, California.

出版信息

Ann Thorac Surg. 2017 Aug;104(2):420-425. doi: 10.1016/j.athoracsur.2017.01.116. Epub 2017 May 9.

DOI:10.1016/j.athoracsur.2017.01.116

PMID:28499653

Abstract

BACKGROUND

To address the limitations of silicone stents, we designed a hinged self-expandable covered metallic stent. The aim of this study was to evaluate the safety and efficacy of the customized stents in clinical applications.

METHODS

This was a retrospective analysis. Under conscious sedation and local anesthesia, the stents were implanted or removed by interventional radiologists, with fluoroscopic guidance.

RESULTS

Of 24 patients with benign main bronchial stenosis, stents were successfully placed in 21 (87.5%). The low-pressure balloon before dilation failed in 1 case (4.17%) of left main bronchial cicatricial stenosis. In 2 other cases (8.33%), stent placement was abandoned. Stents were successfully removed between 29 and 103 days after the procedure. After stent removal, the follow-up lasted for at least 12 months. Restenosis occurred only in 1 case (4.55%) owing to bronchial collapse 3 days after stent removal. Dyspnea occurred in another case (4.55%) at 2 months after retrieval; recurrence was confirmed using bronchoscopy, leading to a left pneumonectomy.

CONCLUSIONS

The described procedure is safe and easy to be performed and avoids the use of intubation, bronchoscopy, and general anesthesia.

摘要

背景

为解决硅酮支架的局限性，我们设计了一种带铰链的自膨胀覆膜金属支架。本研究的目的是评估定制支架在临床应用中的安全性和有效性。

方法

这是一项回顾性分析。在清醒镇静和局部麻醉下，由介入放射科医生在透视引导下植入或取出支架。

结果

24例良性主支气管狭窄患者中，21例（87.5%）成功置入支架。1例（4.17%）左主支气管瘢痕性狭窄患者在扩张前使用低压球囊失败。另外2例（8.33%）放弃支架置入。术后29至103天成功取出支架。取出支架后，随访至少持续12个月。仅1例（4.55%）在取出支架3天后因支气管塌陷发生再狭窄。另1例（4.55%）在取出后2个月出现呼吸困难；经支气管镜检查证实复发，导致左肺切除术。