Chest
Clinical InvestigationsSelf-expandable Metallic Airway Stent Insertion Employing Flexible Bronchoscopy: Preliminary Results
Section snippets
Materials and Methods
Patients suspected of having a large airway obstruction underwent FB to confirm the diagnosis and assess the need for stent placement, with or without laser photoresection (LPR). The length of the obstructed segment was measured by withdrawing the tip of the FB from its distal to the proximal end. An estimate of the length as well as the diameter of the corresponding normal airway was also obtained from a three-dimensional CT scan of the chest. Pulmonary function tests (PFTs) were performed as
Results
Between April 1995 and August 1997, we placed 52 stents in 37 patients. There were 24 men and 13 women, with a mean age of 56 years (range, 31 to 94 years). Indications for stenting included symptomatic airway obstruction from tracheobronchomalacia (TBM [n=13]), neoplasia (n=20), and tracheal stenosis (TS [n=6]). Number, size, and location of stent deployment are shown in Table 1.
Of the 37 patients, 19 presented with chronic symptoms (worsening cough or dyspnea) and 18 had acute symptoms (acute
Discussion
The success of metallic stents in the esophagus, biliary, and vascular tree has led to their subsequent use in the tracheobronchial tree. The advantages of the metallic stents are ease of placement, visibility on an ordinary radiograph, dynamic expandability, and preservation of ventilation when placed across lobar orifices.4
The recently introduced Wallstent is an example of an SEMS. Its design provides a characteristic outward radial force, which is exerted uniformly over the tracheobronchial
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Presented at the annual session of the American College of Chest Physicians, New Orleans, October 26–30, 1997.