Filler R M, Forte V, Fraga J C, Matute J
Department of Surgery, University of Toronto, Ontario, Canada.
J Pediatr Surg. 1995 Jul;30(7):1050-5; discussion 1055-6. doi: 10.1016/0022-3468(95)90340-2.
Expandable metallic angioplasty stents (Palmaz stent) have been implanted in the trachea and/or bronchi of seven children. Three children had severe tracheal stenosis after tracheoplasty for congenital tracheal stenosis repair, and four had tracheomalacia or bronchomalacia with or without vascular compression. The mean age at stenting was 9.7 months (range, 2 to 15 months). Balloon expandable stents were inserted into the trachea or bronchus through a 3.5-mm bronchoscope under fluoroscopic control. Initially a single tracheal stent was used for all patients except for one with obstruction in the trachea and both bronchi, in whom three stents were implanted. Three children had recurrent airway obstruction 1 month later; one was cured with a second stent; one child died 1 year later; and the other is being treated for heart disease. The others have no serious respiratory problems. The stents in all have been in place for 1 to 25 (mean, 11) months. No immediate complications were noted. Early and late bronchoscopy showed incomplete epithelialization of the stent and patches of granulation tissue on it. Two stents were removed bronchoscopically, one at the completion of treatment for tracheomalacia and the other at the time of recurrent airway obstruction. This preliminary experience indicates that expandable metallic stents have a useful role in the treatment of selected lower airway obstructions.
可扩张金属血管成形术支架（Palmaz支架）已被植入7名儿童的气管和/或支气管。3名儿童在先天性气管狭窄修复的气管成形术后出现严重气管狭窄，4名儿童患有气管软化症或支气管软化症，伴有或不伴有血管受压。置入支架时的平均年龄为9.7个月（范围为2至15个月）。在荧光透视控制下，通过3.5毫米支气管镜将球囊可扩张支架插入气管或支气管。除1例气管和双侧支气管均有阻塞的患儿植入了3个支架外，最初所有患儿均使用单个气管支架。3名儿童在1个月后出现复发性气道阻塞；1例通过植入第二个支架治愈；1例儿童在1年后死亡；另1例正在接受心脏病治疗。其他患儿无严重呼吸问题。所有支架已在位1至25个月（平均11个月）。未发现即刻并发症。早期和晚期支气管镜检查显示支架上皮化不完全，表面有肉芽组织斑。通过支气管镜取出了2个支架，1个在气管软化症治疗结束时取出，另1个在复发性气道阻塞时取出。这一初步经验表明，可扩张金属支架在治疗某些下气道阻塞方面具有一定作用。
