Carolina Serrano1,2, Alicia Laborda3, Juan M Lozano4, Hugo Caballero5, Antonio Sebastián6, Jorge Lopera7, Miguel Ángel de Gregorio3,8. 1. Surgical Pathology Unit, Animal Pathology Department, University of Zaragoza, C/ Miguel Servet nº 177, 50013, Zaragoza, Spain. carolina.serrano@unizar.es. 2. Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain. carolina.serrano@unizar.es. 3. Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain. 4. Radiology Department, Marly Clinic, Bogotá, Colombia. 5. Pulmonology Department, Marly Clinic, Bogotá, Colombia. 6. Pulmonology Department, Lozano Blesa Clinical University Hospital, Zaragoza, Spain. 7. Interventional Radiology Deparment, Health Science Center, San Antonio, TX, USA. 8. Intervencional Radiology Department, Lozano Blesa Clinical University Hospital, Zaragoza, Spain.
Abstract
PURPOSE: To present the 7-year experience of the treatment of benign and malignant tracheobronchial stenoses using metallic stents. PATIENTS AND METHODS: One hundred twenty-three stents were inserted in 86 patients (74 benign and 12 malignant stenoses). Ninety-seven stents were placed in the trachea and 26 in the bronchi. The procedures were performed under fluoroscopic and flexible bronchoscopic guidance with the patient under light sedation. In cases of severe stenotic lesions or obstructions, laser resection was performed before stent placement. Clinical and functional pulmonary data were recorded before and 3 months after the procedure. Follow-up involved clinical data and radiographic techniques at 48 h and at 1-, 3-, 6-, and 12-month intervals. RESULTS: The technical success was 100 %. Dyspnea disappearance, forced expiratory volume in the first second, and pulmonary functional data improvement was observed in all patients (p < 0.001). Complications were detected in 23 patients (26.7 %). Mean follow-up time was 6.3 ± 1.2 months in patients with malignant lesions and 76.2 ± 2.3 months patients with in benign lesions. By the end of the study, 100 % of patients with malignant pathology and 6.7 % of patients with benign lesions had died. CONCLUSION: Endoluminal treatment of tracheobronchial stenosis with metallic stents is a therapeutic alternative in patients who are poor candidates for surgery. In unresectable malignant lesions, the benefit of metallic stenting is unquestionable. In benign lesions, the results are satisfactory, but sometimes other interventions are required to treat complications. New stent technology may improve these results.
PURPOSE: To present the 7-year experience of the treatment of benign and malignant tracheobronchial stenoses using metallic stents. PATIENTS AND METHODS: One hundred twenty-three stents were inserted in 86 patients (74 benign and 12 malignant stenoses). Ninety-seven stents were placed in the trachea and 26 in the bronchi. The procedures were performed under fluoroscopic and flexible bronchoscopic guidance with the patient under light sedation. In cases of severe stenotic lesions or obstructions, laser resection was performed before stent placement. Clinical and functional pulmonary data were recorded before and 3 months after the procedure. Follow-up involved clinical data and radiographic techniques at 48 h and at 1-, 3-, 6-, and 12-month intervals. RESULTS: The technical success was 100 %. Dyspnea disappearance, forced expiratory volume in the first second, and pulmonary functional data improvement was observed in all patients (p < 0.001). Complications were detected in 23 patients (26.7 %). Mean follow-up time was 6.3 ± 1.2 months in patients with malignant lesions and 76.2 ± 2.3 months patients with in benign lesions. By the end of the study, 100 % of patients with malignant pathology and 6.7 % of patients with benign lesions had died. CONCLUSION: Endoluminal treatment of tracheobronchial stenosis with metallic stents is a therapeutic alternative in patients who are poor candidates for surgery. In unresectable malignant lesions, the benefit of metallic stenting is unquestionable. In benign lesions, the results are satisfactory, but sometimes other interventions are required to treat complications. New stent technology may improve these results.