Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, No.1, East Jian She Road, Zhengzhou, 450052, China.
Radiol Med. 2019 Mar;124(3):191-198. doi: 10.1007/s11547-018-0953-9. Epub 2018 Oct 24.
To study the safety and effectiveness of fluoroscopic insertion and removal of self-expandable metallic airway stent for post-tracheotomy tracheal stenosis (PTTS) and post-intubation tracheal stenosis (PITS).
We conducted a retrospective analysis of 32 patients who underwent fluoroscopic stenting from September 2011 to March 2017. The patients ranged in age from 12 to 69 years. Thirty-eight airway stents were implanted, 35 covered stents and three bare stents. Nineteen airway stents were used for 16 cases of PITS or PTTS. All patients underwent chest CT scans with/without bronchoscopy prior to stent removal. The indication of stent removal and post-interventional complications were analyzed.
All 38 airway stents were successfully inserted. Insufficient expansion and tissue hyperplasia were most common complications after stenting. Thirty five of 38 airway stents were successfully removed fluoroscopically, with a technical success rate of 92.1%. Routine removal was performed after 2.9 ± 0.3 months, and stent restenosis was found after a mean duration of 2.7 ± 0.3 months. There were six complications of stent removal with no death. Four stents showed strut fracture after removal, of which three stent pieces retained. Two patients showed dyspnea immediately after removal and required mechanical ventilation in PTTS. One patient with PTTS lost of follow-up during a mean period of 33.7 ± 3.9 months. The one-, three- and five-year patency rates were 87.1%, 76.2% and 70.8%, respectively. There was no significant difference between PITS and PTTS.
Fluoroscopic insertion and removal of airway stent is safe and effective for PITS and PTTS. A three-month retention time is reasonable for airway stents.
研究透视引导下自膨式金属气道支架置入和取出在气管切开后气道狭窄（PTTS）和气管插管后气道狭窄（PITS）中的安全性和有效性。
我们回顾性分析了 2011 年 9 月至 2017 年 3 月期间 32 例接受透视下支架置入的患者。患者年龄 12 至 69 岁，共植入 38 枚气道支架，其中 35 枚为覆膜支架，3 枚为裸支架。19 枚气道支架用于 16 例 PITS 或 PTTS 患者。所有患者在支架取出前均行胸部 CT 扫描（有/无支气管镜）。分析支架取出的适应证和介入后并发症。
所有 38 枚气道支架均成功置入。支架置入后最常见的并发症是支架扩张不全和组织增生。38 枚气道支架中有 35 枚经透视成功取出，技术成功率为 92.1%。常规取出时间为 2.9±0.3 个月，平均支架再狭窄时间为 2.7±0.3 个月。有 6 例支架取出并发症，无死亡病例。取出后有 4 枚支架出现支架断裂，其中 3 枚支架碎片保留。2 例 PTTS 患者在取出后即刻出现呼吸困难，需要机械通气。1 例 PTTS 患者在平均 33.7±3.9 个月时失访。1、3、5 年通畅率分别为 87.1%、76.2%和 70.8%，PITS 和 PTTS 之间无显著差异。
透视引导下气道支架置入和取出对 PITS 和 PTTS 安全有效，气道支架留置 3 个月较为合理。
