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Do airway metallic stents for benign lesions confer too costly a benefit?
BACKGROUND: The use of self-expanding metallic stents (SEMAS) in the treatment benign airway obstruction is controversial. METHODS: To evaluate the safety and efficacy of SEMAS for this indication, we conducted a 10-year retrospective review at our tertiary medical centre. RESULTS: Using flexible br...
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2008
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386774/ https://www.ncbi.nlm.nih.gov/pubmed/18423035 http://dx.doi.org/10.1186/1471-2466-8-7 |
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author | Chan, Andrew L Juarez, Maya M Allen, Roblee P Albertson, Timothy E |
author_facet | Chan, Andrew L Juarez, Maya M Allen, Roblee P Albertson, Timothy E |
author_sort | Chan, Andrew L |
collection | PubMed |
description | BACKGROUND: The use of self-expanding metallic stents (SEMAS) in the treatment benign airway obstruction is controversial. METHODS: To evaluate the safety and efficacy of SEMAS for this indication, we conducted a 10-year retrospective review at our tertiary medical centre. RESULTS: Using flexible bronchoscopy, 82 SEMAS (67% Ultraflex, 33% Wallstent) were placed in 35 patients with inoperable lesions, many with significant medical comorbidities (88%). 68% of stents were tracheal, and 83% of patients showed immediate symptomatic improvement. Reversible complications developed in 9% of patients within 24 hrs of stent placement. Late complications (>24 hrs) occurred in 77% of patients, of which 37% were clinically significant or required an interventional procedure. These were mainly due to stent migration (12.2%), fracture (19.5%), or obstructive granulomas (24.4%). The overall granuloma rate of 57% was higher at tracheal sites (59%) than bronchial ones (34%), but not significantly different between Ultraflex and Wallstents. Nevertheless, Wallstents were associated with higher rates of bleeding (5% vs. 30%, p = 0.005) and migration (7% vs. 26%, p = 0.026). Of 10 SEMAS removed using flexible bronchoscopy, only one was associated with incomplete removal of fractured stent wire. Median survival was 3.6 ± 2.7 years. CONCLUSION: Ill patients with inoperable lesions may be considered for treatment with SEMAS. |
format | Text |
id | pubmed-2386774 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-23867742008-05-17 Do airway metallic stents for benign lesions confer too costly a benefit? Chan, Andrew L Juarez, Maya M Allen, Roblee P Albertson, Timothy E BMC Pulm Med Research Article BACKGROUND: The use of self-expanding metallic stents (SEMAS) in the treatment benign airway obstruction is controversial. METHODS: To evaluate the safety and efficacy of SEMAS for this indication, we conducted a 10-year retrospective review at our tertiary medical centre. RESULTS: Using flexible bronchoscopy, 82 SEMAS (67% Ultraflex, 33% Wallstent) were placed in 35 patients with inoperable lesions, many with significant medical comorbidities (88%). 68% of stents were tracheal, and 83% of patients showed immediate symptomatic improvement. Reversible complications developed in 9% of patients within 24 hrs of stent placement. Late complications (>24 hrs) occurred in 77% of patients, of which 37% were clinically significant or required an interventional procedure. These were mainly due to stent migration (12.2%), fracture (19.5%), or obstructive granulomas (24.4%). The overall granuloma rate of 57% was higher at tracheal sites (59%) than bronchial ones (34%), but not significantly different between Ultraflex and Wallstents. Nevertheless, Wallstents were associated with higher rates of bleeding (5% vs. 30%, p = 0.005) and migration (7% vs. 26%, p = 0.026). Of 10 SEMAS removed using flexible bronchoscopy, only one was associated with incomplete removal of fractured stent wire. Median survival was 3.6 ± 2.7 years. CONCLUSION: Ill patients with inoperable lesions may be considered for treatment with SEMAS. BioMed Central 2008-04-18 /pmc/articles/PMC2386774/ /pubmed/18423035 http://dx.doi.org/10.1186/1471-2466-8-7 Text en Copyright © 2008 Chan et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Chan, Andrew L Juarez, Maya M Allen, Roblee P Albertson, Timothy E Do airway metallic stents for benign lesions confer too costly a benefit? |
title | Do airway metallic stents for benign lesions confer too costly a benefit? |
title_full | Do airway metallic stents for benign lesions confer too costly a benefit? |
title_fullStr | Do airway metallic stents for benign lesions confer too costly a benefit? |
title_full_unstemmed | Do airway metallic stents for benign lesions confer too costly a benefit? |
title_short | Do airway metallic stents for benign lesions confer too costly a benefit? |
title_sort | do airway metallic stents for benign lesions confer too costly a benefit? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386774/ https://www.ncbi.nlm.nih.gov/pubmed/18423035 http://dx.doi.org/10.1186/1471-2466-8-7 |
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