Cook C H, Bhattacharyya N, King D R
Department of Pediatric Surgery, Children's Hospital, The Ohio State University College of Medicine, Columbus, USA.
J Pediatr Surg. 1998 Aug;33(8):1306-8. doi: 10.1016/s0022-3468(98)90175-0.
Indications for using expandable metal stents (EMS) for airway disease have expanded considerably during the past decade. Complications have been infrequent but can be potentially life threatening. There are four reported instances of vascular bronchial fistula after Gianturco EMS insertion for managing airway disease in adults. The authors report a case of an aortobronchial fistula in a pediatric patient after Palmaz EMS insertion for treatment of bronchomalacia. A 14-year-old boy with severe scoliosis underwent left mainstem bronchus insertion of two Palmaz stents in tandem for correction of complete bronchial obstruction caused by vascular compression. Three weeks later fatal hemoptysis from an aortobronchial fistula developed. Elective EMS insertion for treatment of airway obstruction secondary to compression by vascular structures should be approached with caution. EMS placement should be reserved for situations in which there is no other reasonable surgical alternative.
在过去十年中，可扩张金属支架（EMS）用于气道疾病的适应证已大幅扩展。并发症并不常见，但可能危及生命。据报道，在成人气道疾病管理中，插入Gianturco EMS后有4例血管支气管瘘。作者报告了1例儿科患者在插入Palmaz EMS治疗支气管软化后发生主动脉支气管瘘的病例。一名患有严重脊柱侧弯的14岁男孩因血管压迫导致完全性支气管阻塞，接受了两枚Palmaz支架串联置入左主支气管以纠正阻塞。三周后，因主动脉支气管瘘引发致命咯血。对于因血管结构压迫继发气道阻塞而进行的择期EMS置入应谨慎对待。EMS放置应仅用于没有其他合理手术替代方案的情况。
