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Abstract No. 257: Metallic stents for tracheobronchial pathology treatment
JVIR 䡲 Scientific Session
Wednesday 䡲 S105
procedures (n ⫽ 1). The mean symptomatic improvement period was 56 days (95% CI, 25-87 days). The symptomatic improvement rates were at 1 year, 3 years and 5 years were 36%, 36% and 43%, respectively. Conclusion: Fluoroscopically-guided balloon dilation seems to be effective and safe for patients with post-intubation tracheal stenoses.
11:34 AM
Abstract No. 256
Outcomes of tracheobronchial temporary partial covered stent placement for benign disease X. Han, J. Ma, G. Wu; Zhengzhou university, Zhengzhou, China
11:42 AM
Purpose: To present our 7 years of experience in the treatment of benign and malignant tracheobronchial stenosis using metallic stents. Materials and Methods: 123 stents were deployed in 86 patients (74 benign and 12 malignant stenosis): 97 in the trachea, 17 in the main left bronchus,7 in the main right bronchus and 1 in the intermediate bronchus. The procedures were performed under general anaesthesia and laryngeal mask, with fluoroscopic and flexible broncoscopic guidance. In case of severe stenotic lesions or obstruction, laser resection was performed preprocedure. Patients were followed-up clinically and by thorax imaging at 48 hours and at 1,3,6 and 12 months and by functional tests at 3 months. Results: Technical success was of 100%. Clinical improvement was observed in all patients: dyspnea disappearance and pulmonary functional data improvement (see Table). Complications were detected in 23 patients (26.7%). The follow-up mean time was of 6.3⫾1.2 months in malignant lesions and 76.2⫾2.3 months in benign lesions. At the end of the study, 100% of the patients with malignancy and 6.7% of the rest were deceased. Functional Pulmonary Data
Parameter
Pre-treatment (Mean ⫾ SD)
Post-treatment (Mean ⫾ SD)
p*
FEV1 (mL) FVC (mL) PEF (L/min) FEF50 (L/min) PIF (L/min) FIF50 (L/min) TOTAL RAW (cmH20/L/s) TLC (mL) RV (mL)
1751.5 ⫾ 829.7 3157.8 ⫾ 1044.6 262.49 ⫾ 190.93 150.98 ⫾ 116.76 201.03 ⫾ 133.82 173.85 ⫾ 135.57 1.75 ⫾ 2.18 575.24 ⫾ 202.68 284.04 ⫾ 202.46
2694.7 ⫾ 953.8 3488.9 ⫾ 107.21 578.63 ⫾ 261.28 295.84 ⫾ 165.43 388.65 ⫾ 180.01 370.00 ⫾ 196.70 0.63 ⫾ 1.19 568.17 ⫾ 147.66 216.77 ⫾ 119.47
⬍0.001 ⬍0.001 ⬍0.001 ⬍0.001 ⬍0.001 ⬍0.001 ⬍0.001 0.704 0.001
* Significance according to T-student Test for paired samples FEV1 Forced expiratory volume in first second FVC Forced vital capacity PEF Peak expiratory flow FEF50 Forced expiratory volumen at 50% PIF peak inspiratory flow FIF forced inspiratory flow at 50% TOTAL RAW Total resistances of the airway TLC total lung capacity RV residual volume.
Conclusion: Minimally invasive treatment of tracheobronchial stenosis with metallic stents is a therapeutic alternative in patients which are not good candidates for surgery. A correct assessment of the patient is essential to choose the best treatment.
Scientific Session 20 Embolization III Wednesday, March 28, 2012 10:30 AM – 12:00 PM Room: 122
Abstract No. 257
Metallic stents for tracheobronchial pathology treatment A. Laborda1, J.M. Lozano2, H. Caballero2, C. Serrano1, A. Sebastian3, J. Lopera4, M.A. de Gregorio1; 1GITMIUniversidad de Zaragoza, Zaragoza, Spain; 2 Department of Radiology, Marly Clinic, Bogota, Colombia; 3Department of Pulmonology, Hospital
10:30 AM
Abstract No. 258
Efficacy and safety of selective arterial embolization with fibrin glue in the treatment of
WEDNESDAY: Scientific Sessions
Purpose: To retrospectively determine mid-term outcomes in patients who have undergone temporary partial covered tracheobronchial stent placement for benign diseases. Materials and Methods: This is a retrospective analysis of consecutives 34 patients (23 women , 11 men; mean age, 35 years; range, 18-54 years) who received the stent placement between January 2009 and March 2011.Causes of airway stenosis included tracheal tube injury (n⫽5), tracheobronchomalacia (n ⫽4), tracheal amyloid (n ⫽6), endobronchial tuberculosis (n⫽19). 15 patients were treated with temporary partial covered stent and 19 with temporary partial covered branched stent. All of the stent were removed after approximately 85 to 95 days of placement. Respiratory function test was prospectively performed before and 1 day after stent placement. Respiratory function was assessed in terms of visual analog scale (VAS) and Karnofsky Performance Status (KPS). All cases were scheduled for clinical and imaging follow up using CT at before stent placement, 1 month, six months after removal of the stent. To measure the diameter of the stenosis on CT. Results: 34 stent placement performed on 34 patients were retrospectively reviewed. The procedure was completed in all patients without complications. VAS and KPS significantly improved (p⬍0.05) from average of 6.291⫾0.495 to 1.493⫾0.504 and 25.352⫾10.533 to 60.140⫾16.344 respectively. Mean diameter of the stenosis in trachea and main bronchus were 7.876⫾2.351mm and 2.143⫾0.770mm before stent placement, 17.235⫾3.457mm and 8.993⫾0.961mm at 1 month after removal of the stent, 16.353⫾4.132mm and 8.357⫾1.082mm at 6 months after removal of the stent. Statistically significant difference between diameter of the stenosis before stent placement and that at 1 month after removal of the stent was indentified (p⬍0.05), statistically significant difference between diameter of the stenosis before stent placement and that at 6 months after removal of the stent was indentified (p⬍0.05), although no significant deference between 1 month after removal of the stent and 6 months after removal of the stent was noted. Conclusion: Temporary partial covered stent is feasible and effective to manage with benign tracheobronchial stenosis.
Clinico Lozano Blesa, Zaragoza, Spain; 4Interventional Radiology Department, Health Science Center, San Antonio, TX
Wednesday 䡲 S105
procedures (n ⫽ 1). The mean symptomatic improvement period was 56 days (95% CI, 25-87 days). The symptomatic improvement rates were at 1 year, 3 years and 5 years were 36%, 36% and 43%, respectively. Conclusion: Fluoroscopically-guided balloon dilation seems to be effective and safe for patients with post-intubation tracheal stenoses.
11:34 AM
Abstract No. 256
Outcomes of tracheobronchial temporary partial covered stent placement for benign disease X. Han, J. Ma, G. Wu; Zhengzhou university, Zhengzhou, China
11:42 AM
Purpose: To present our 7 years of experience in the treatment of benign and malignant tracheobronchial stenosis using metallic stents. Materials and Methods: 123 stents were deployed in 86 patients (74 benign and 12 malignant stenosis): 97 in the trachea, 17 in the main left bronchus,7 in the main right bronchus and 1 in the intermediate bronchus. The procedures were performed under general anaesthesia and laryngeal mask, with fluoroscopic and flexible broncoscopic guidance. In case of severe stenotic lesions or obstruction, laser resection was performed preprocedure. Patients were followed-up clinically and by thorax imaging at 48 hours and at 1,3,6 and 12 months and by functional tests at 3 months. Results: Technical success was of 100%. Clinical improvement was observed in all patients: dyspnea disappearance and pulmonary functional data improvement (see Table). Complications were detected in 23 patients (26.7%). The follow-up mean time was of 6.3⫾1.2 months in malignant lesions and 76.2⫾2.3 months in benign lesions. At the end of the study, 100% of the patients with malignancy and 6.7% of the rest were deceased. Functional Pulmonary Data
Parameter
Pre-treatment (Mean ⫾ SD)
Post-treatment (Mean ⫾ SD)
p*
FEV1 (mL) FVC (mL) PEF (L/min) FEF50 (L/min) PIF (L/min) FIF50 (L/min) TOTAL RAW (cmH20/L/s) TLC (mL) RV (mL)
1751.5 ⫾ 829.7 3157.8 ⫾ 1044.6 262.49 ⫾ 190.93 150.98 ⫾ 116.76 201.03 ⫾ 133.82 173.85 ⫾ 135.57 1.75 ⫾ 2.18 575.24 ⫾ 202.68 284.04 ⫾ 202.46
2694.7 ⫾ 953.8 3488.9 ⫾ 107.21 578.63 ⫾ 261.28 295.84 ⫾ 165.43 388.65 ⫾ 180.01 370.00 ⫾ 196.70 0.63 ⫾ 1.19 568.17 ⫾ 147.66 216.77 ⫾ 119.47
⬍0.001 ⬍0.001 ⬍0.001 ⬍0.001 ⬍0.001 ⬍0.001 ⬍0.001 0.704 0.001
* Significance according to T-student Test for paired samples FEV1 Forced expiratory volume in first second FVC Forced vital capacity PEF Peak expiratory flow FEF50 Forced expiratory volumen at 50% PIF peak inspiratory flow FIF forced inspiratory flow at 50% TOTAL RAW Total resistances of the airway TLC total lung capacity RV residual volume.
Conclusion: Minimally invasive treatment of tracheobronchial stenosis with metallic stents is a therapeutic alternative in patients which are not good candidates for surgery. A correct assessment of the patient is essential to choose the best treatment.
Scientific Session 20 Embolization III Wednesday, March 28, 2012 10:30 AM – 12:00 PM Room: 122
Abstract No. 257
Metallic stents for tracheobronchial pathology treatment A. Laborda1, J.M. Lozano2, H. Caballero2, C. Serrano1, A. Sebastian3, J. Lopera4, M.A. de Gregorio1; 1GITMIUniversidad de Zaragoza, Zaragoza, Spain; 2 Department of Radiology, Marly Clinic, Bogota, Colombia; 3Department of Pulmonology, Hospital
10:30 AM
Abstract No. 258
Efficacy and safety of selective arterial embolization with fibrin glue in the treatment of
WEDNESDAY: Scientific Sessions
Purpose: To retrospectively determine mid-term outcomes in patients who have undergone temporary partial covered tracheobronchial stent placement for benign diseases. Materials and Methods: This is a retrospective analysis of consecutives 34 patients (23 women , 11 men; mean age, 35 years; range, 18-54 years) who received the stent placement between January 2009 and March 2011.Causes of airway stenosis included tracheal tube injury (n⫽5), tracheobronchomalacia (n ⫽4), tracheal amyloid (n ⫽6), endobronchial tuberculosis (n⫽19). 15 patients were treated with temporary partial covered stent and 19 with temporary partial covered branched stent. All of the stent were removed after approximately 85 to 95 days of placement. Respiratory function test was prospectively performed before and 1 day after stent placement. Respiratory function was assessed in terms of visual analog scale (VAS) and Karnofsky Performance Status (KPS). All cases were scheduled for clinical and imaging follow up using CT at before stent placement, 1 month, six months after removal of the stent. To measure the diameter of the stenosis on CT. Results: 34 stent placement performed on 34 patients were retrospectively reviewed. The procedure was completed in all patients without complications. VAS and KPS significantly improved (p⬍0.05) from average of 6.291⫾0.495 to 1.493⫾0.504 and 25.352⫾10.533 to 60.140⫾16.344 respectively. Mean diameter of the stenosis in trachea and main bronchus were 7.876⫾2.351mm and 2.143⫾0.770mm before stent placement, 17.235⫾3.457mm and 8.993⫾0.961mm at 1 month after removal of the stent, 16.353⫾4.132mm and 8.357⫾1.082mm at 6 months after removal of the stent. Statistically significant difference between diameter of the stenosis before stent placement and that at 1 month after removal of the stent was indentified (p⬍0.05), statistically significant difference between diameter of the stenosis before stent placement and that at 6 months after removal of the stent was indentified (p⬍0.05), although no significant deference between 1 month after removal of the stent and 6 months after removal of the stent was noted. Conclusion: Temporary partial covered stent is feasible and effective to manage with benign tracheobronchial stenosis.
Clinico Lozano Blesa, Zaragoza, Spain; 4Interventional Radiology Department, Health Science Center, San Antonio, TX