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- Title
A small bifurcated self-expanding metallic stent for malignant bronchial fistula or severe stenosis around the upper left carina.
- Authors
Bi, Yonghua; Li, Jindong; Wu, Gang; Yu, Zepeng; Han, Xinwei; Ren, Jianzhuang
- Abstract
Background: Bifurcated self-expanding metallic stents have mainly been primarily used for the treatment of airway disease around the main carina, but few studies have reported the use of small bifurcated stents to treat malignant bronchial fistula or severe stenosis around the upper left carina. Purpose: We aimed to determine the safety, feasibility, and efficacy of small metallic bifurcated stent placement in the upper left carina. Material and Methods: Twenty-two patients with malignant bronchial disease were treated with small bifurcated stents. All bifurcated stents were custom-designed according to the measurement of CT measurements and placed under local anesthesia with fluoroscopic guidance. Clinical outcomes and CT imaging data were retrospectively analyzed. Results: A total of 27 stents were used in 22 patients, with two stents removed immediately after placement due to stent insufficient dilation and failure of sealing fistula. Twenty patients underwent successful treatment, with a technical success of 90.9%. Thirteen complications were found in 9 (40.9%) patients. Five patients underwent successful stent removal due to failure of sealing fistula (n = 2) or because they were effectively cured (n = 3) during the follow-up period. Ten patients died of cancer, one patient died of chronic renal failure, and one died of myocardial infarction. The one-, three-, and five-year survival rates were 48.0%, 40.0%, and 32.0%, respectively. The median survival was 12.7 months. Conclusion: Small bifurcated self-expanding metallic stents are a safe and effective treatment option for malignant bronchial fistula or severe stenosis around the upper left carina, but complications are relatively high. Further prospective studies are needed to evaluate alternative treatment options.
- Subjects
BRONCHIAL fistula; BRONCHIAL diseases; CHRONIC kidney failure; STENOSIS; THERAPEUTICS; MYOCARDIAL infarction
- Publication
Acta Radiologica, 2020, Vol 61, Issue 5, p613
- ISSN
0284-1851
- Publication type
journal article
- DOI
10.1177/0284185119875631