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犬气管塌陷综合征内镜下支架置入术后气管尺寸、支架尺寸与主要并发症的相关性。

Correlations among tracheal dimensions, tracheal stent dimensions, and major complications after endoluminal stenting of tracheal collapse syndrome in dogs.

机构信息

Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York.

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

出版信息

J Vet Intern Med. 2019 Sep;33(5):2209-2216. doi: 10.1111/jvim.15555. Epub 2019 Jul 9.

Abstract

BACKGROUND

Endoluminal tracheal stenting can relieve signs associated with tracheal collapse syndrome (TCS) in dogs, but major complications can result.

OBJECTIVE

To identify associations among tracheal dimensions, stent dimensions, and subsequent complications requiring additional stent placement after endoluminal stenting for TCS.

ANIMALS

Fifty-two dogs from the hospital population.

METHODS

Medical records of dogs that received an endoluminal self-expanding tracheal stent for TCS by the interventional radiology service between 2009 and 2014 were reviewed for relevant data. Signalment and clinical details, including tracheal collapse type, tracheal measurements, nominal stent dimensions, follow-up evaluation times, and stent complications, were recorded.

RESULTS

Fifty-two dogs that received an endoluminal stent for TCS met the inclusion criteria. Major complications included stent fracture (13/52; 25%), obstructive tissue ingrowth (10/52; 19%), and progressive tracheal collapse (6/52; 12%). Natural tracheal taper (P = .04) and more stent diameter oversizing (P = .04) in the intrathoracic (IT) trachea were associated with caudodorsal stent fracture. Only stents with a 14-mm nominal diameter fractured. Progressive tracheal collapse was associated with smaller maximum tracheal diameters (P = .02). The majority of dogs with obstructive tissue ingrowth (7/10; 70%; P = .30) and all dogs with thoracic inlet fractures (3/3; 100%) had tracheal malformations.

CONCLUSIONS AND CLINICAL IMPORTANCE

A higher taper in tracheal diameter may lead to increased risk of fracture in the IT location. Dogs with tracheal malformations may have higher risk for thoracic inlet fracture and development of obstructive tissue ingrowth. Clinicians should be aware of the possible risk factors for tracheal stent complications.

摘要

背景

气管腔内支架置入术可缓解犬气管塌陷综合征(TCS)相关症状,但可能会出现严重并发症。

目的

确定气管尺寸、支架尺寸与 TCS 行腔内支架置入后需再次放置支架的相关并发症之间的关系。

动物

医院就诊犬 52 只。

方法

回顾 2009 年至 2014 年间,介入放射科为 TCS 行腔内自膨式气管支架置入术的犬的病历,记录相关数据。记录一般信息和临床特征,包括气管塌陷类型、气管测量值、支架标称尺寸、随访评估时间和支架并发症。

结果

52 只犬因 TCS 行腔内支架置入术,符合纳入标准。主要并发症包括支架断裂(13/52;25%)、阻塞性组织过度生长(10/52;19%)和进行性气管塌陷(6/52;12%)。胸内段(IT)气管自然气管变细(P =.04)和支架直径过大(P =.04)与支架背侧断裂有关。只有 14mm 标称直径的支架发生断裂。进行性气管塌陷与最大气管直径较小有关(P =.02)。大多数发生阻塞性组织过度生长的犬(7/10;70%;P =.30)和所有发生胸入口骨折的犬(3/3;100%)都有气管畸形。

结论和临床意义

气管直径的锥形越大,IT 部位的断裂风险可能越高。有气管畸形的犬可能有更高的胸入口骨折和阻塞性组织过度生长的风险。临床医生应了解气管支架并发症的可能危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acda/6766514/23dbf910d473/JVIM-33-2209-g001.jpg

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