Mauricio Lozano MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: Present our experience during the last 5 years (September 1997-December2002) with metallic stents in the treatment of benign and malignant stenosis of the tracheobronchial tree. Methods and Materials: We inserted 75 stents (40 Palmaz stents, 28 Ultraflex, 5 Symphony and 2 Jostent)in 50 patients (40 with benign stenosis and 10 with malignant stenosis). 15 patients had stenosis post intubation or tracheostomy, 13 post tracheal surgery, 2 with Wegener's granulomatosis, 1 broncholitiasis, 1 papillomatosis, 2 rinoescleromas, 2 tuberculosis, 3 tracheobronchomalacia and 1 with osteocondroplastic tracheobronchopathy . The distribution of the patients with malignant diseases was: 3 bronchogenic carcinomas, 2 esophagic carcinomas with tracheal infiltration, 2 hipernephroma metastases, 1 cystic adenoid carcinoma of the trachea and 1 carcinoid tumor. 57 stents were inserted in the trachea (76%), 5 in right main stem bronchus (6.6%), 12 in the left main stem bronchus (16%) and 1 in the intermediate bronchus (1.3%). We used the flexible bronchoscope under general anesthesia or sedation in order to identify the location and extention of the stenosis and a combination of endoscopic and fluoroscopic guidance to establish the exact position of the stent. We passed a guidewire far from the stenosis and then, without bronchoscope, with fluoroscopic guidance the stent delivery system was advanced to the desired position and the stent was progressively deployed until liberated from its delivery catether or was delivered with a pneumatic balloon. According to the case a laser resection or a ballon dilatation was performed before inserting the stent Results: Initial technical success was achieved in all patients. Patients were studied with funtional respiratory test after and before stenting. All the funtional test was improvement after treatment. None patient died in relation with the stenting. Our complications were twelve reestenoses for granuloma formation, five stents fractures that were changed, and one perforation with tracheo bronchial fistulae; all complications can be managed by interventional techniques by our team with ballons, laser, extraction of the broken stents and new insert, and with insert a cover stent in the perforation. During the follow-up all the benign pathology patients and the malignant alive patients have patent their airways Conclusion: Our results show that using stents in tacheobronchial stenosis is an apropiate and safe procedure with few complications that can be managed by interventional technics without surgery.       Questions about this event email: jlozano@andinet.com

Lozano MD, M, Benefit of the No Surgical Treatment of the Tracheobronchial Stenosis with Metalic Stents.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3100042.html