Tracheal Stricture and Fistula: Management With a Barbed Silicone-Covered Retrievable Expandable Nitinol Stent

被引:12
作者
Kim, Yong Hee [3 ]
Shin, Ji Hoon [1 ,2 ]
Song, Ho-Young [1 ,2 ]
Kim, Jin Hyoung [1 ,2 ]
机构
[1] Univ Ulsan, Coll Med, Dept Radiol, Asan Med Ctr, Seoul 138736, South Korea
[2] Univ Ulsan, Coll Med, Res Inst Radiol, Asan Med Ctr, Seoul 138736, South Korea
[3] Univ Ulsan, Coll Med, Dept Thorac & Cardiovasc Surg, Asan Med Ctr, Seoul 138736, South Korea
关键词
fistula; obstruction; prosthesis; stenosis; stent; trachea; TERM-FOLLOW-UP; TRACHEOBRONCHIAL STRICTURES; ESOPHAGEAL STENT; ENDOBRONCHIAL PATHOLOGY; METALLIC STENTS; AIRWAY STENTS; MIGRATION; FIXATION; OBSTRUCTION; PALLIATION;
D O I
10.2214/AJR.09.3025
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
OBJECTIVE. The purpose of this study was to evaluate the safety and effectiveness of a barbed silicone-covered retrievable expandable nitinol stent in preventing stent migration in patients with tracheal strictures or fistulas. SUBJECTS AND METHODS. Under fluoroscopic guidance, barbed silicone-covered retrievable expandable nitinol stents were placed in 15 patients with tracheal strictures, two patients with fistulas, two patients with combined strictures and fistulas, and one patient with variable extrathoracic airway obstruction. The three pairs of barbs were attached to the external stent surface at the middle of the stent at equal intervals. Technical success, improvement in respiratory status, complications, and related interventions were evaluated. RESULTS. The technical success rate was 100%, and respiratory status improved or the fistula closed in all 20 patients. Complications included sputum retention (three patients), tumor overgrowth (three patients), pain (one patient), and granulation tissue formation (one patient). No stent migration occurred, even in the three patients without fixed strictures. Four stents subsequently were removed because of complications, and one stent was removed because the patient's condition improved. Stent removal was not difficult and was uneventful. The silicone membranes and barbs of the removed stents were intact. CONCLUSION. Use of a barbed silicone-covered retrievable expandable nitinol stent relieves dyspnea and facilitates fistula closure in patients with benign or malignant tracheal strictures or fistulas. The barbed design of the stent is important in preventing migration.
引用
收藏
页码:W232 / W237
页数:6
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