Radlinsky M G, Fossum T W, Walker M A, Aufdemorte T B, Thompson J A
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station 77843-4474, USA.
Vet Surg. 1997 Mar-Apr;26(2):99-107. doi: 10.1111/j.1532-950x.1997.tb01471.x.
This study evaluates the efficacy of the Palmaz balloon expandable intraluminal stent in the trachea and mainstem bronchi of normal dogs.
Effects of the stent were evaluated by physical examination, thoracic radiography, respiratory tract fluoroscopy and endoscopy, tracheal diameter measurement, postmortem examination, and airway histomorphometry.
Ten normal beagle dogs.
Stent size was estimated from thoracic radiographs in awake dogs. Group I dogs (n = 4) had two stents placed: one in the thoracic trachea (TT) plus a randomly chosen mainstem bronchus (MB). Group II dogs (n = 3) had stents placed in the MB (one stent), TT (one stent), and mid- or proximal cervical trachea (CT) (one or two stents). Three dogs were used as sham-operated controls (group III). Temperature, pulse, respiration, and cough were measured twice daily. Dogs were evaluated at 21 and 49 to 56 days after stent placement, euthanatized, and tissues were collected for histomorphometric analysis of stent integration and epithelial pathology.
Mean tracheal diameters of awake (10.5 +/- 1.7 mm) and anesthetized dogs before stent implantation (13.9 +/- 2.0 mm) were significantly different (P < .01). Complications associated with stent placement included acute pulmonary edema (n = 2), stent migration (n = 7), stent collapse (n = 4 CT, 2 TT, and 1 MB), and positive tracheal culture (n = 10). Group II dogs coughed more at rest, exercise, and with tracheal palpation than dogs in other groups (P < .01). Group I dogs coughed more at rest than group III dogs (P < .01). Stent integration ranged from 0 to 91.3%. Squamous metaplasia and epithelial ulceration associated with stents ranged from 0 to 57.5% and 0 to 32.7%, respectively.
Determination of stent size should be based on measurements taken on anesthetized dogs because use of inappropriately sized stents may promote stent migration, squamous metaplasia, and/or ulceration. Epithelialization over stent struts may occur if the stent is closely associated with tracheal epithelium.
Palmaz stents do not appear to be appropriate for placement in the CT of dogs; however, with technical modifications, application in the TT and MB may be feasible.
本研究评估帕尔马兹球囊可扩张腔内支架在正常犬气管及主支气管中的疗效。
通过体格检查、胸部X线摄影、呼吸道荧光透视及内镜检查、气管直径测量、尸检及气道组织形态计量学评估支架效果。
10只正常比格犬。
根据清醒犬的胸部X线片估算支架尺寸。第一组犬（n = 4）植入两个支架：一个置于胸段气管（TT），另一个随机置于主支气管（MB）。第二组犬（n = 3）在MB（一个支架）、TT（一个支架）及颈段气管中、近端（CT）（一个或两个支架）植入支架。三只犬作为假手术对照组（第三组）。每天测量两次体温、脉搏、呼吸及咳嗽情况。在植入支架后21天以及49至56天对犬进行评估，实施安乐死后收集组织，用于支架整合及上皮病理的组织形态计量学分析。
清醒犬（10.5±1.7 mm）及麻醉状态下犬在植入支架前（13.9±2.0 mm）的平均气管直径存在显著差异（P < .01）。与支架植入相关的并发症包括急性肺水肿（n = 2）、支架移位（n = 7）、支架塌陷（n = 4个CT、2个TT和1个MB）以及气管培养阳性（n = 10）。第二组犬在休息、运动及气管触诊时咳嗽比其他组犬更频繁（P < .01）。第一组犬在休息时咳嗽比第三组犬更频繁（P < .01）。支架整合率为0至91.3%。与支架相关的鳞状化生及上皮溃疡分别为0至57.5%和0至32.7%。
应根据麻醉状态下犬的测量结果确定支架尺寸，因为使用尺寸不合适的支架可能会促进支架移位、鳞状化生和/或溃疡形成。如果支架与气管上皮紧密相连，支架支柱上可能会发生上皮化。
帕尔马兹支架似乎不适用于犬的颈段气管；然而，通过技术改进，在胸段气管和主支气管中的应用可能是可行的。
