Author/Authors :
Jiang, Jun-hong Department of Respiratory and Critical Care Medicine - First Affiliated Hospital of Soochow University, Suzhou, China , Zeng, Da-xiong Department of Respiratory and Critical Care Medicine - First Affiliated Hospital of Soochow University, Suzhou, China , Wang, Chang-guo Department of Respiratory and Critical Care Medicine - First Affiliated Hospital of Soochow University, Suzhou, China , Chen, Yan-bin Department of Respiratory and Critical Care Medicine - First Affiliated Hospital of Soochow University, Suzhou, China , Shen, Dan Department of Respiratory and Critical Care Medicine - First Affiliated Hospital of Soochow University, Suzhou, China , Mao, Jin-yu Department of Respiratory and Critical Care Medicine - First Affiliated Hospital of Soochow University, Suzhou, China , J. Francis Turner, Jr. Department of Medicine - Division of Pulmonary & Critical Care Medicine - University of Tennessee Graduate School of Medicine, USA , Huang, Jian-an Department of Respiratory and Critical Care Medicine - First Affiliated Hospital of Soochow University, Suzhou, China
Abstract :
Objective. Self-expandable metallic (SEM) airway stents are an important approach to malignant central airway obstruction
(CAO). SEM airway stent insertions are usually performed under fluoroscopic guidance over a guide wire placed through a flexible
bronchoscope often resulting in a longer procedure time and exposure to radiation. In this pilot study, we designed a novel
delivery system of the through-the-scope (TTS) SEM airway stent insertion and observed its feasibility. Methods. From Jan 2015 to
Sept 2016, 25 consecutive patients with inoperable malignant CAO were enrolled requiring airway stent implantation. All patients
were followed up to death or at least 6 months. Results. 36 TTS stents were inserted into 25 patients using a flexible bronchoscope
under general anesthesia or local anesthesia. All stents were successfully deployed directly through the working channel (2.8 mm
diameter) of the flexible bronchoscope in 91.7% (33/36) of the subjects. .e mMRC score and stenosis grade improved significantly after stent implantation. .e common stent-related complications were secretion retention (25%, 9/36), development of
granulation tissue (13.9%, 5/36), tumor in-growth (13.9%, 5/36), and hemoptysis (8.3%, 3/36). .e 6-month overall survival (OS)
was 44% (11/25). Conclusion. .e novel TTS stent release system was an effective and safe approach in malignant central
airway obstruction.
