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与皮质类固醇洗脱鼻窦支架相关的不良事件:MAUDE数据库分析

Adverse Events Associated With Corticosteroid-Eluting Sinus Stents: A MAUDE Database Analysis.

作者信息

Narwani Vishal, Torabi Sina J, Kasle David A, Patel Rahul A, Lerner Michael Z, Manes R Peter

机构信息

Division of Otolaryngology, Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, USA.

Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut, USA.

出版信息

Otolaryngol Head Neck Surg. 2022 Jan;166(1):179-182. doi: 10.1177/01945998211006930. Epub 2021 Apr 13.

Abstract

OBJECTIVE

Corticosteroid-eluting stents (CESs) are increasingly used after endoscopic sinus surgery to reduce the need for revision surgery, but their use is not without risks. The objective of this study is to describe adverse events related to CESs.

STUDY DESIGN

Retrospective cross-sectional study.

SETTING

The US Food and Drug Administration's MAUDE database (2011-2020; Manufacturer and User Facility Device Experience).

METHODS

The MAUDE database was queried for reports of adverse events involving the use of CESs approved by the Food and Drug Administration, including Propel, Propel Mini, Propel Contour, and Sinuva (Intersect ENT).

RESULTS

There were 28 reported adverse events in total, with all events being related to the Propel family of stents and none related to Sinuva stents. Overall, 22 were categorized as patient-related adverse events and 6 as device-related events. The most common adverse event was related to postoperative infection, accounting for 39% (n = 11) of all complications. Four of these patients developed periorbital cellulitis, and 5 developed a fungal infection. The second-most common adverse event was migration of the stent, representing 21% of all complications (n = 6). Overall, 8 patients (29%) in our cohort required reintervention in the operating room, with subsequent removal of the CES.

CONCLUSION

The most commonly reported adverse events were postoperative infection, including multiple cases of fungal infection, followed by migration of the stent. An increased awareness of the complications associated with CESs can be used to better inform patients during the consenting process as well as surgeons in their surgical decision making.

摘要

目的

在内镜鼻窦手术后,越来越多地使用皮质类固醇洗脱支架(CESs)以减少翻修手术的需求,但其使用并非没有风险。本研究的目的是描述与CESs相关的不良事件。

研究设计

回顾性横断面研究。

研究地点

美国食品药品监督管理局的MAUDE数据库(2011 - 2020年;制造商和用户设施设备经验)。

方法

查询MAUDE数据库中涉及使用美国食品药品监督管理局批准的CESs的不良事件报告,包括Propel、Propel Mini、Propel Contour和Sinuva(Intersect ENT)。

结果

总共报告了28例不良事件,所有事件均与Propel系列支架相关,与Sinuva支架无关。总体而言,22例被归类为与患者相关的不良事件,6例为与设备相关的事件。最常见的不良事件与术后感染有关,占所有并发症的39%(n = 11)。其中4例患者发生眶周蜂窝织炎,5例发生真菌感染。第二常见的不良事件是支架移位,占所有并发症的21%(n = 6)。总体而言,我们队列中的8例患者(29%)需要在手术室进行再次干预,随后取出CES。

结论

最常报告的不良事件是术后感染,包括多例真菌感染,其次是支架移位。提高对与CESs相关并发症的认识,可用于在知情同意过程中更好地告知患者,并帮助外科医生进行手术决策。

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