Petersen B D, Uchida B T, Barton R E, Keller F S, Rösch J
Dotter Interventional Institute, Oregon Health Sciences University, Portland 97201-3098, USA.
J Vasc Interv Radiol. 1995 Nov-Dec;6(6):925-31. doi: 10.1016/s1051-0443(95)71214-3.
To evaluate expandable metallic Gianturco-Rösch Z (GRZ) stents for treatment of benign and malignant tracheobronchial stenoses.
Six patients, ages 45-73 years, were treated for severe dyspnea with placement of GRZ stents. Three patients had benign tracheal lesions (one tracheomalacia, two postoperative) and received uncovered GRZ stents. Three patients had malignant stenoses at the level of the carina; one received an uncovered stent and the other two received silicone-covered GRZ stents.
Two patients with benign lesions responded well to stent placement. One was asymptomatic for a year and then was lost to follow-up; the other improved substantially but died of end-stage lung disease 5 months after stent placement. A third patient with a benign high tracheal lesion did poorly; symptoms recurred secondary to inferior migration of a stent, which was removed surgically at 4 months. All patients with malignant lesions improved symptomatically after stent placement and remained without significant dyspnea until death (from 1 to 6 months).
Expandable GRZ stents are promising devices for treatment of benign lesions and offer effective palliation of malignant tracheobronchial stenoses.
评估可扩张金属Gianturco-Rösch Z(GRZ)支架治疗良性和恶性气管支气管狭窄的效果。
6例年龄在45 - 73岁之间的患者因严重呼吸困难接受了GRZ支架置入治疗。3例患者有良性气管病变(1例气管软化,2例术后),接受了裸GRZ支架。3例患者在隆突水平有恶性狭窄;1例接受裸支架,另外2例接受硅胶覆盖的GRZ支架。
2例良性病变患者对支架置入反应良好。1例患者无症状达1年,之后失访;另1例患者症状明显改善,但在支架置入后5个月死于终末期肺病。第3例患有高位良性气管病变的患者情况不佳;由于支架向下移位,症状复发,4个月后手术取出支架。所有恶性病变患者在支架置入后症状均有改善,直至死亡(1至6个月)前均无明显呼吸困难。
可扩张GRZ支架是治疗良性病变的有前景的器械,对恶性气管支气管狭窄有有效的姑息治疗作用。