Department of Respiratory Medicine, NHO Okayama Medical Center, Japan.
Department of Respiratory Medicine, Hosoya Hospital, Japan.
Intern Med. 2024 Aug 15;63(16):2277-2282. doi: 10.2169/internalmedicine.3048-23. Epub 2024 Jan 13.
Objective Airway stenting is an established procedure for treating various airway disorders. The AERO stent (Merit Medical Systems, South Jordan, USA) is a fully covered self-expandable metallic stent approved for use in Japan in 2014. However, its effectiveness in treating malignant airway disorders in patients with a poor performance status remains unclear. Therefore, we investigated the safety and efficacy of the AERO stent in patients with malignant airway disorders and a poor performance status. Methods We retrospectively reviewed the medical records of all patients who underwent AERO stent placement at our institute between April 2016 and March 2022, and 21 patients underwent 25 procedures for malignant airway disorders. All AERO stenting procedures were performed using an over-the-wire delivery system with flexible and/or rigid bronchoscopy. Results Eighteen of the 21 patients (85.7%) had a poor general condition (Eastern Cooperative Oncology Group performance status 3 or 4). AERO stents were successfully placed in 23 of the 25 procedures and migrated in the remaining 2 cases. Complications occurred in 10 cases, with infection being the most common (3 cases). Fourteen patients (66.6%) showed an improvement in their performance status. In addition, 5 of the 6 intubated patients were extubated following AERO stenting, and 11 patients subsequently received anticancer treatment. Conclusion The placement of the AERO stent is useful in patients with a poor performance status, including those who are intubated and afflicted with malignant airway disorders.
气道支架置入术是治疗各种气道疾病的一种成熟方法。AERO 支架(美国犹他州南乔丹的美敦力公司制造)是一种完全覆盖的自扩张金属支架,2014 年在日本获得批准使用。然而,其在治疗身体状况较差的恶性气道疾病患者中的有效性尚不清楚。因此,我们研究了 AERO 支架在身体状况较差的恶性气道疾病患者中的安全性和疗效。
我们回顾性分析了 2016 年 4 月至 2022 年 3 月期间在我院接受 AERO 支架置入术的所有患者的病历,其中 21 例患者因恶性气道疾病接受了 25 次 AERO 支架置入术。所有 AERO 支架置入术均采用经导丝输送系统,结合软性或硬性支气管镜进行。
21 例患者中有 18 例(85.7%)一般状况较差(东部肿瘤协作组体力状态 3 或 4 级)。25 次手术中有 23 次成功放置了 AERO 支架,其余 2 例支架发生迁移。10 例患者发生并发症,以感染最为常见(3 例)。14 例患者(66.6%)的体力状况得到改善。此外,在接受 AERO 支架置入术后,6 例气管插管患者中有 5 例拔管,11 例患者随后接受了抗癌治疗。
对于身体状况较差的患者,包括气管插管和患有恶性气道疾病的患者,AERO 支架的置入是有用的。