Short-Term Use of Uncovered Self-Expanding Metallic Airway Stents for Severe Expiratory Central Airway Collapse
| Autor: | Sebastian Ochoa, Sidhu P. Gangadharan, Daniel Alape, Adnan Majid, Erik Folch, Fayez Kheir, Alejandro Folch |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Time Factors Databases Factual medicine.medical_treatment Self Expandable Metallic Stents Silicones 030204 cardiovascular system & hematology Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Bronchoscopy Self-expandable metallic stent Tracheobronchoplasty Severity of illness medicine Humans Airway Management Device Removal Aged Retrospective Studies Tracheobronchomalacia medicine.diagnostic_test business.industry Granulation tissue Stent Middle Aged medicine.disease Surgery medicine.anatomical_structure Treatment Outcome 030228 respiratory system Pneumothorax Anesthesia Quality of Life Female business Airway Tomography X-Ray Computed |
| Zdroj: | Respiration; international review of thoracic diseases. 92(6) |
| ISSN: | 1423-0356 |
| Popis: | Background: Patients with severe symptomatic expiratory central airway collapse (ECAC) undergo a stent trial to determine whether they are candidate for tracheobronchoplasty. Most stent trials were done using silicone stents. However, there was a higher number of silicone stent-related complications. Objectives: The aim of this study was to evaluate the safety and efficacy of short-term uncovered self-expanding metallic airway stents (USEMAS) in patients with ECAC. Methods: This was a retrospective review. Baseline measurements were compared to those obtained after 7-14 days. Measurements included: Modified Medical Research Council (mMRC), Cough Quality of Life Questionnaire (CQLQ), spirometry testing, and 6-Minute Walk Test (6MWT). Stent- and procedure-related complications were reported. Results: 33 patients (median age, 52 years) underwent the USEMAS trial. Presenting symptoms were dyspnea in 100%, intractable cough in 90.3%, recurrent infection in 42.2%, and inability to clear secretions in 21.4%. Dyspnea, cough, and secretion clearance improved in 88, 70, and 57%, respectively. Overall, there was a significant improvement in mMRC (p < 0.001), CQLQ (p = 0.015), and 6MWT (p = 0.015). There was 1 airway infection, 1 stent migration, and 1 pneumothorax. The median duration of USEMAS was 7 days. All stents were removed without any complications. At the time of stent removal, no granulation tissue was observed in 30.9%, and mild granulation tissue was observed in 69.1%. Conclusion: The short-term USEMAS trial improves respiratory symptoms, quality of life, and exercise capacity with few complications in patients with severe symptomatic ECAC when performed by a multidisciplinary airway team in highly specialized centers with experience in the evaluation and treatment of this patient population. |
| Databáze: | OpenAIRE |
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