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气管塌陷综合征犬放置气管支架后,气管支架直径、长度和位置的即刻、短期和长期变化。

Immediate, short-, and long-term changes in tracheal stent diameter, length, and positioning after placement in dogs with tracheal collapse syndrome.

作者信息

Raske Matthew, Weisse Chick, Berent Allyson C, McDougall Renee, Lamb Kenneth

机构信息

The Animal Medical Center, New York, New York.

Lamb Statistical Consulting LLC, West St. Paul, Minnesota.

出版信息

J Vet Intern Med. 2018 Mar;32(2):782-791. doi: 10.1111/jvim.15063. Epub 2018 Feb 20.

Abstract

BACKGROUND

Intraluminal tracheal stenting is a minimally invasive procedure shown to have variable degrees of success in managing clinical signs associated with tracheal collapse syndrome (CTCS) in dogs.

OBJECTIVES

Identify immediate post-stent changes in tracheal diameter, determine the extent of stent migration, and stent shortening after stent placement in the immediate-, short-, and long-term periods, and evaluate inter-observer reliability of radiographic measurements.

ANIMALS

Fifty client-owned dogs.

METHODS

Retrospective study in which medical records were reviewed in dogs with CTCS treated with an intraluminal tracheal stent. Data collected included signalment, location, and type of collapse, stent diameter and length, and post-stent placement radiographic follow-up times. Radiographs were used to obtain pre-stent tracheal measurements and post-stent placement measurements.

RESULTS

Immediate mean percentage change was 5.14%, 5.49%, and 21.64% for cervical, thoracic inlet, and intra-thoracic tracheal diameters, respectively. Ultimate mean follow-up time was 446 days, with mean percentage change of 2.55%, 15.09%, and 8.65% for cervical, thoracic inlet, and intra-thoracic tracheal diameters, respectively. Initial mean stent length was 26.72% higher than nominal length and ultimate long-term tracheal mean stent shortening was only 9.90%. No significant stent migration was identified in the immediate, short-, or long-term periods. Good inter-observer agreement of radiographic measurements was found among observers of variable experience level.

CONCLUSIONS AND CLINICAL IMPORTANCE

Use of an intraluminal tracheal stent for CTCS is associated with minimal stent shortening with no clinically relevant stent migration after fluoroscopic placement. Precise stent sizing and placement techniques likely play important roles in avoiding these reported complications.

摘要

背景

气管腔内支架置入术是一种微创手术,在治疗犬气管塌陷综合征(CTCS)相关临床症状方面显示出不同程度的成功。

目的

确定支架置入后即刻、短期和长期气管直径的即刻变化,确定支架移位程度和支架缩短情况,并评估影像学测量的观察者间可靠性。

动物

50只客户拥有的犬。

方法

回顾性研究,对接受气管腔内支架治疗的CTCS犬的病历进行回顾。收集的数据包括信号、塌陷位置和类型、支架直径和长度以及支架置入后的影像学随访时间。使用X线片获取支架置入前和置入后的气管测量值。

结果

颈部、胸廓入口和胸段气管直径的即刻平均百分比变化分别为5.14%、5.49%和21.64%。最终平均随访时间为446天,颈部、胸廓入口和胸段气管直径的平均百分比变化分别为2.55%、15.09%和8.65%。初始平均支架长度比标称长度高26.72%,最终长期气管平均支架缩短仅为9.90%。在即刻、短期或长期均未发现明显的支架移位。不同经验水平的观察者之间在影像学测量上具有良好的观察者间一致性。

结论及临床意义

对于CTCS,气管腔内支架的使用与最小的支架缩短相关,透视下置入后无临床相关的支架移位。精确的支架尺寸选择和置入技术可能在避免这些报道的并发症中起重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6aa/5867008/ad285dd3e528/JVIM-32-782-g001.jpg

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