Klinische Erfahrungen mit Gianturco-Z-Stents bei endotrachealen und -bronchialen Stenosen

Rauber, K.; Weimar, B.; Hofmann, Manfred; Jaschke, Werner; Morr, H; Ws, Rau

doi:10.1055/s-2008-1032834

Cited by 8 publications

(3 citation statements)

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“…[13][14][15] The implantation of uncovered Wallstents in the trachea of adult human patients is limited because only diameters up to 22 mm are available. [13][14][15] In animals (dogs and rabbits), experimental studies were performed to evaluate the endotracheal placement of balloon-expanded standard iliac Palmaz-Schatz stents 16 and thermal shape-memory nickel-titanium (NiTi) alloys. 17 These studies determined that placement of Palmaz-Schatz stents was associated with a high rate of complications, including development of pneumothorax, infection, mucous plugs resulting in tracheal obstruction, stent migration, and compression of the upper stent ends.…”

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confidence: 99%

Management of Advanced Tracheal Collapse in Dogs Using Intraluminal Self-Expanding Biliary Wallstents

2004

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Twenty-four client-owned dogs with tracheal collapse refractory to conventional treatment underwent management with an intraluminal self-expanding stainless-steel endoprosthesis (Wallstent). Initial improvement of clinical signs was observed in 95.8% of the dogs. Two dogs (8.3%) died within a median interval of 6 days after stent implantation due to incorrect placement and size of the stent and emphysema, respectively. A dry cough occurred temporarily in most of the patients. One dog each (4.1%) suffered mild transient tracheal hemorrhage and pneumomediastinum. The results showed that the initial survival rate of intraluminal stabilization was comparable with surgical implantation of extratracheal prostheses. Clinical reevaluation was performed in 18 dogs within a median interval of 68 days after treatment. Of the dogs treated, 30.4% were reported to be asymptomatic after stent implantation, 60.9% improved markedly, and 4.3% remained symptomatic. In all patients undergoing endoscopy, the Wallstents were almost completely covered with tracheal epithelium. A median shortening of 27.3% of the endoprosthesis within a median interval of 175 days after stent implantation in 15 of 18 dogs was noted. The shortening was associated with clinical signs in 2 patients. In 5 dogs, steroid-responsive granuloma formation resulted in a severe reduction of the tracheal lumen in 3 patients. The results suggest that implantation of Wallstents was minimally invasive and provided stabilization of collapsed thoracic tracheal portions in addition to the cervical part of the trachea. This minimally invasive method for the management of severe tracheal collapse therefore provides an attractive alternative to surgery.

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Management of Advanced Tracheal Collapse in Dogs Using Intraluminal Self-Expanding Biliary Wallstents

2004

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“…There are no comparative trials. Any implanted stent must undergo cyclic stress, thus increasing the risk of stent migration [7], mucosal injury [18], fatigue fracture [19][20][21], and corrosion cracking. In a series of TBM patients who received a Z-stent made of 0.46-mm-diameter wire, 31% (6 of 19 cases) experienced stent complications, including fracture; one case was fatal and two of these patients had the stent removed [7].…”

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confidence: 99%

A Dedicated Z-Stent for Acquired Saber-Sheath Tracheobronchomalacia

Kishi¹,

Fujimoto

Sonomura

et al. 1997

Cardiovasc Intervent Radiol

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The tracheobronchial lumen has a continuous horseshoe arch morphology. We formed Z-stents accordingly to support the weakened cartilagenous portions. With this type of stent we treated a patient with acquired saber-sheath type tracheobronchomalacia (TBM), Rayl's type II, Johnson's grade III, whose condition was aggravated even under positive end expiratory pressure (PEEP) therapy. The patient improved gradually. No immediate complication was observed. Bronchofiberscopic examination revealed that the tracheobronchial arcade was closely strut-braced and showed no expiratory collapse. Six months later, when the patient was intubated due to asthmatic attacks, tissue ingrowth through the stent was found and removed. There was no recurrence of TBM. The patient died 2 years later of pneumoconiosis.

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“…Self-expandable metallic stents are frequently used in the tracheobronchial tree for the palliation of either benign or malignant airway obstruction or stenosis [3,4,7,10,12,14,[16][17][18][19][20]. The treatment of patients with malignant airway obstruction has been improved by the recent introduction of expandable metallic stents that may be used as the sole palliative treatment or as an adjuvant to other treatment modalities.…”

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A combination of laser therapy, radiation therapy, and stent placement for the palliation of complete malignant bronchial obstruction

et al. 1998

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We treated a complete obstruction of the left mainstem bronchus due to nonresectable recurrent esophageal carcinoma with a combination of laser therapy, radiation therapy, and the placement of an expandable metallic stent. The patient survived 1 year after the first therapy, with good quality of life. We conclude that a combination of laser ablation, radiotherapy, and stent placement can improve survival and quality of life for the patients with complete malignant bronchial obstruction.

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Klinische Erfahrungen mit Gianturco-Z-Stents bei endotrachealen und -bronchialen Stenosen

Cited by 8 publications

References 0 publications

Management of Advanced Tracheal Collapse in Dogs Using Intraluminal Self-Expanding Biliary Wallstents

Management of Advanced Tracheal Collapse in Dogs Using Intraluminal Self-Expanding Biliary Wallstents

A Dedicated Z-Stent for Acquired Saber-Sheath Tracheobronchomalacia

A combination of laser therapy, radiation therapy, and stent placement for the palliation of complete malignant bronchial obstruction

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