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开发一种用于气管支架置入的创新介入方法。

Developing an innovative interventional approach for stenting trachea.

作者信息

Mazraehei Farahani Maryam, Kajbafzadeh Abdol-Mohammad, Kiani Arda, Kazemizadeh Hossein, Baghani Mostafa

机构信息

Farhikhtegan Medical Convergence Sciences Research Center, Farhikhtegan Hospital Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.

Department of Pulmonary Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

BMJ Surg Interv Health Technol. 2025 May 8;7(1):e000180. doi: 10.1136/bmjsit-2022-000180. eCollection 2025.

DOI:10.1136/bmjsit-2022-000180
PMID:40390791
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12086876/
Abstract

OBJECTIVES

Stenting is a method of controlling airway occlusions (CAO) that can be used alone or in combination with other treatments. There are different types of airway stents. One of the most widely used types is silicone stent. These stents are flexible and firm enough cylinders inserted into the airway by a rigid scope to relieve dyspnoea caused by CAO in malignant and non-malignant diseases. We have developed a method that can be applied quickly in remote urgent cases without a rigid scope.

DESIGN

We used two endotracheal tubes with a size of 8.5 for stenting.

SETTING

This research was conducted at Pediatric Urology and Regenerative Medicine Research Center, Children's Medical Center, Pediatric Center of Excellence, Animal Lab Tehran University of Medical Sciences, Tehran, Iran (IR).

PARTICIPANTS INSTEAD OF PATIENTS OR SUBJECTS

Two certified mature sheep (ewes).

INTERVENTIONS

Silicone stent placement for 2 months.

MAIN OUTCOME MEASURES

A method with minimal facilities for stenting without limitation of trachea size.

RESULTS

A pilot animal study has been performed on two mature certified sheep to test a stenting procedure. Stenting procedures have been successfully implemented on the animals' trachea.

CONCLUSIONS

We have developed a new simple, fast and cheap procedure for stenting silicon stents with minimum risk. We can easily place and rotate the stent during the procedure.

摘要

目的

支架置入是一种控制气道阻塞（CAO）的方法，可单独使用或与其他治疗方法联合使用。气道支架有不同类型。最广泛使用的类型之一是硅胶支架。这些支架是足够柔韧且坚固的圆柱体，通过硬质内镜插入气道，以缓解恶性和非恶性疾病中CAO引起的呼吸困难。我们开发了一种无需硬质内镜即可在远程紧急情况下快速应用的方法。

设计

我们使用两根8.5号气管内导管进行支架置入。

地点

本研究在伊朗德黑兰医科大学儿童医学中心儿科泌尿外科和再生医学研究中心、卓越儿科中心、动物实验室进行（IR）。

参与者而非患者或受试者

两只经认证的成年绵羊（母羊）。

干预措施

放置硅胶支架2个月。

主要观察指标

一种设施最少、不受气管尺寸限制的支架置入方法。

结果

对两只成年经认证的绵羊进行了一项试点动物研究，以测试一种支架置入程序。已在动物气管上成功实施了支架置入程序。

结论

我们开发了一种新的简单、快速且廉价的程序，用于置入硅胶支架，风险最小。在操作过程中，我们可以轻松放置和旋转支架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/20cebd2acb9c/bmjsit-7-1-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/306b488034f7/bmjsit-7-1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/d46ed6ae2095/bmjsit-7-1-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/323fe1fff375/bmjsit-7-1-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/4327980ce089/bmjsit-7-1-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/db02fa37134f/bmjsit-7-1-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/20cebd2acb9c/bmjsit-7-1-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/306b488034f7/bmjsit-7-1-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/d46ed6ae2095/bmjsit-7-1-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/323fe1fff375/bmjsit-7-1-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/4327980ce089/bmjsit-7-1-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/db02fa37134f/bmjsit-7-1-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1abd/12086876/20cebd2acb9c/bmjsit-7-1-g006.jpg

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本文引用的文献

1
Tracheobronchial stents in patients with malignant airway disease: Finnish tertiary care experience.恶性气道疾病患者的气管支气管支架：芬兰三级医疗护理经验
Interact Cardiovasc Thorac Surg. 2021 Oct 4;33(4):557-563. doi: 10.1093/icvts/ivab147.
2
External fixation of airway stents for upper tracheal stenosis and tracheoesophageal fistula.气道支架外固定治疗高位气管狭窄和气管食管瘘。
Interact Cardiovasc Thorac Surg. 2021 Aug 18;33(3):442-447. doi: 10.1093/icvts/ivab098.
3
Tracheoesophageal Fistula in a COVID-19 Ventilated Patient: A Challenging Therapeutic Decision.
Case Rep Surg. 2021 Mar 30;2021:6645518. doi: 10.1155/2021/6645518. eCollection 2021.
4
Modified silicone stent for the treatment of post-surgical bronchopleural fistula: a clinical observation of 17 cases.改良型硅胶支架治疗术后支气管胸膜瘘 17 例临床观察。
BMC Pulm Med. 2021 Jan 6;21(1):10. doi: 10.1186/s12890-020-01372-8.
5
Using individualized three-dimensional printed airway models to guide airway stent implantation.使用个体化三维打印气道模型指导气道支架植入。
Interact Cardiovasc Thorac Surg. 2020 Dec 7;31(6):900-903. doi: 10.1093/icvts/ivaa206.
6
Double stent insertion for combined malignant airway and superior vena cava obstruction.双支架置入术治疗恶性气道与上腔静脉联合梗阻
Medicine (Baltimore). 2019 May;98(21):e15777. doi: 10.1097/MD.0000000000015777.
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Indications and complications of rigid bronchoscopy.硬质支气管镜检查的适应证和并发症。
Expert Rev Respir Med. 2018 Jun;12(6):509-520. doi: 10.1080/17476348.2018.1473037. Epub 2018 May 8.
8
Complete subglottic tracheal stenosis managed with rigid bronchoscopy and T-tube placement.采用硬质支气管镜检查和T形管置入术治疗的完全性声门下气管狭窄。
Lung India. 2016 Nov-Dec;33(6):661-663. doi: 10.4103/0970-2113.192879.
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J Thorac Dis. 2015 Dec;7(Suppl 4):S352-62. doi: 10.3978/j.issn.2072-1439.2015.11.17.
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