• Title/Summary/Keyword: Airway stent

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THE PROBLEMS OF EXPANDABLE METALLIC STENT FOR THE TREATMENT OF SUBGLOTTIC TRACHEAL AND TRACHEOSTOMAL STENOSIS (성문하 기관 및 기관누공 협착증에 대한 팽창성 금속 스텐트의 문제점)

  • 홍기환;정경호;김중호;한영민
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.213-221
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    • 1996
  • To evaluate the clinical effectiveness of expandable metallic stents, the stents were implanted under endoscopic guidance with local anesthesia or general anesthesia for maintenance of the constructed subglottic space of trachea. The nine patients with respiration difficulty were subjected for expandable stents. The stenosis of upper airway were due to the framework problem of subglottic trachea and tracheostoma after total laryngectomy. Stents were constructed of 0.4 m stainless steel win in a zigzag configuration of 8 bends. A single stent was 20 m in diameter when fully expanded and 20 mm long. The stents were placed accurately to the stenotic site and followed to the 5 month after stent placement. The stenotic area became narrowed with overgrowing of granuloma in all patients and the metallic stents were removed and the stenotic area reconstructed surgically. As conclusion, this technique for the treatment of the subglottic trachea showed simple and safe, but highly recurred due to overgrowing of granuloma. We suggest that the expandable metallic stent is not encouraging in this study.

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Successful Treatment of Tracheal Invasion Caused by Thyroid Cancer Using Endotracheal Tube Balloon Inflation under Flexible Bronchoscopic Guidance

  • Han, Yang-Hee;Jung, Bock-Hyun;Kwon, Jun Sung;Lim, Jaemin
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.5
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    • pp.215-218
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    • 2014
  • Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.

Dual Stent Application on Congenital Tracheobronchial Stenosis - 1 case - (선천성 기관기관지 협착에서의 이중 스텐트의 적용 - 1례 보고 -)

  • 강문철;황성욱;김용진;김희수;김종성;성명훈
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.149-152
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    • 2002
  • We report successful application of dual trachcobronchial stcnt to the diffuse tracheal stenosis. An one-month-old boy was transferred to the emergency room due to tachypnea and respiratory difficulty with COB retention. Preoperative computed tomography revealed pulmonary artery sling with diffuse tracheal stenosis. We found that the diameter of the both main bronchus was less than 3mm and the trachea was a complete ring. We divided the left pulmonary artery and implanted it to the main pulmonary artery under cardiopulmonary bypass. After that, tracheoplasty was performed with autologous pericardium. However, after the initial measures, CO2 retention and respiratory difficulty persisted due to the granulation tissue and dynamic obstruction of the airway ensued by the overlying pericardial flap. Therefore, we decided to apply a single tracheal stunt. After the insertion of tracheal stent, residual stenosis of the both main bronchus opening continued to cause respiratory difficulty Finally we applied dual tracheobronchial stent and resolved the airway obstruction.

A Case of Postpneumonectomy Syndrome Treated with Endobronchial Stent (기관지 스텐트 삽입으로 치료한 전폐절제술후 증후군 1예)

  • Jeong, Seong-Hyun;Cho, Hye-Jin;Lee, Hyoung-No;Lee, Hyung-Sook;Sheen, Seung-Soo;Oh, Yoon-Jung;Park, Kwang-Joo;Hwang, Sung-Chul;Won, Jae-Hwan;Park, Kyung-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.325-331
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    • 2002
  • Postpneumonectomy syndrome is a rare complication that usually occurs in younger patients within the first year after a right total lung resection. Its clinical presentations are stridor, dyspnea, and recurrent pulmonary infections. An airway obstruction secondary to the extreme mediastinal shift and ratation after a pneumonectomy is the main mechanism. It is commonly complicated with tracheobronchomalacia due to longstanding airway compression. The management modalities involve a repositioning of the mediastinum with volume expansion of the pneumonectomy site by a expandable prosthesis. however, other methods including an endobronchial stent insertion should be considered in the presence of a tracheobronchomalacia or in poor surgical candidates. Here we describe a case of postpneumonectomy syndrome complicated by a bronchomalacia, which was successfully treated with a self-expandable endobronchal stent.

A Case of Complication of Expandible Metallic Stent with Endobronchial Stenosis (결핵성 기관지 협착시 팽창성 금속 스텐트 시행후 발생한 육아종 형성 1예)

  • Lim, Seong-Hee;You, Kwan-Hee;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.1
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    • pp.47-50
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    • 1994
  • To maintain an adequate airway in a patient with tracheobronchial narrowing coming from various causes, prosthetic tracheobronchial stents provide palliative treatment for narrowed airways where surgical resection is inadvisable. After insertion, previous reported complications were granuloma formation, dysphagia, suction catheter entrapment and fatal massive hemoptysis. We report, a case of complication associated with expandible metallic stent with endobronchial stenosis due to tuberculosis.

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Surgical Treatment of Bronchial Restenosis Occuring After Insertion of Self-Expandable Metalic Stent in Patients with Bronchial Stenosis -2 Cases Reports- (기관지협착환자에서 기관지내 팽창성 급속 스텐트 삽입후 재발한 기관지협착 치험 2례)

  • Kim, Woo-Chan;Jin, Ung;Rha, Suk-Joo;Jo, Keon-Hyon;Lee, Sun-Hee;Kwack, Moon-Sub;Kim, Se-Wha
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.499-503
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    • 1995
  • Since the insertion of self expandable metalic stent[SEMS has became popular method for hollow organ stenosis, many attempts for further apply the stent to airway stenosis as an simple procedure has been made, but intrabronchial migration of stent or occurrence of inflammatory granuloma around stent develop occasionally and sometimes it worsen bronchial stenosis further more. This report describes 2 case of surgically treated bronchial restenosis in whom intrabronchial stent were applied for release of bronchial stenosis. Our surgical option was pneumonectomy and bronchoplasty with sleeve right middle and upper lobectomy respectively. During the operation we found the SEMSs were tightly impacted in restenotic bronchial lumen with overgrowth of granulation tissues. The bronchial obstructions occupied more than 90% of lumens in both cases, and needed much complicated procedure to be relieved. Therefore, even though the insertion of SEMS remains as a prcedure determined by the physician`s preference, it has to be considered prudently that the use of SEMS can cause severe restenosis and the surgeon has more difficulties in performing segmental resection of restenotic bronchus in patient with SEMS previously inserted. Throughout these experiences we can conclude that the insertion of SEMS must be performed only in very selected cases of bronchial stenosis.

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Clinical Experience of Rigid Bronchoscopy in Single Center

  • Kim, Hyun-Jin;Kim, Sei-Won;Lee, Hye-Yeon;Kang, Hyeon-Hui;Kang, Ji-Young;Kim, Ju-Sang;Kim, Myung-Sook;Kim, Seung-Soo;Kim, Jin-Woo;Yun, Hyeong-Gyu;Kim, Chi-Hong;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Cho, Kwang-Jae;Moon, Seok-Hwan;Lee, Sang-Haak
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.6
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    • pp.486-492
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    • 2012
  • Background: The aim of this study was to analyze clinical situations requiring rigid bronchoscopy and evaluate usefulness of rigid bronchoscopic intervention in benign or malignant airway disorders. Methods: We retrospectively reviewed 29 patients who underwent rigid bronchoscopy from November 2007 to February 2011 at St. Paul's Hospital, The Catholic University of Korea School of Medicine. Results: Of the 29 patients, the most frequent underlying etiology was benign stenosis of trachea (n=20). Of those 20 patients, 16 had post-intubation tracheal stenosis (PITS), 2 had tracheal stenosis due to inhalation burn (IBTS) and other 2 had obstructive fibrinous tracheal pseudomembrane (OFTP). Other etiologies were airway malignancy (n=6), endobronchial stenosis due to tuberculosis (n=2), and foreign body (n=1). For treatment, silicone stent insertion was done in 16 cases of PITS and IBTS and mechanical removal was performed in 2 cases of OFTP. In 6 cases of malignant airway obstruction mechanical debulking was performed and silicone stents were inserted additionally in 2 cases. Balloon dilatation and electrocautery were used in 2 cases of endobronchial stenosis due to tuberculosis. In all cases of stent, airway obstructive symptom improved immediately. Granulation tissue formation was the most common complication. Conclusion: Tracheal stenosis was most common indication and silicone stenting was most common procedure of rigid bronchoscopy in our center. Rigid bronchoscopic procedures, at least tracheal silicone stenting, should be included in pulmonary medicine fellowship programs because it is a very effective and indispensable method to relieve critical airway obstruction which needs training to learn.

Lung lobe torsion in a dog with a tracheal stent for severe tracheal collapse

  • Taeho Lee;Aryung Nam;Dong-Kwan Lee;Han-Joon Lee;Kun-Ho Song
    • Korean Journal of Veterinary Service
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    • v.46 no.4
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    • pp.349-355
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    • 2023
  • A 7-year-old castrated male Pomeranian dog presented with severe goose honking cough and dyspnea. Thoracic radiographs revealed a narrowed tracheal diameter at the thoracic inlet, classified as tracheal collapse grade 4. Despite medical treatment, the dog's life-threatening airway obstruction did not improve. Subsequently, tracheal stent placement resulted in a significant improvement in respiratory condition, with no recurrence of symptoms observed during the 4-month period, except for coughing induced by excitement and anxiety. However, the patient presented with a one-week history of productive cough, exercise intolerance, and loss of appetite. Radiographs and computed tomography scans revealed torsion of the left cranial lung lobe. The patient underwent affected lung lobectomy, which involved the removal of the necrotized cranial portion and heavily congested caudal portion. Unfortunately, the patient did not recover and eventually passed away. Histopathological examination of the resected lung tissue confirmed coagulative necrosis and marked peribronchiolar edema, consistent with lung lobe torsion.

Interventional Management of Malignant Esophagorespiratory Fistula and Bronchopleural Fistula (악성 기관지호흡기루와 기관지흉강루에 대한 인터벤션 치료)

  • Shin, Ji-Hoon;Kim, Kyung-Rae;Kim, Jin-Hyoung;Song, Ho-Young
    • Korean Journal of Bronchoesophagology
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    • v.14 no.1
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    • pp.8-13
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    • 2008
  • Malignant esophagorespiratory fistula is a devastating and life-threatening complication of esophageal and bronchogenic carcinomas. As a non-surgical treatment, peroral stent placement into the esophagus or airway can close-off the fistula and prevent progression of the pneumonia. Although reopening of the fistula is not uncommon despite stent placement, interventional treatment is effective for sealing off reopened ERFs. Bronchopleural fistula is a well-recognized complication of pneumonectomy. There have been several reports to occlude the fistula with use of stents and much more experience is required.

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