AI Article Synopsis
- The study evaluates the safety and effectiveness of self-expanding metallic stents (SEMAS) for treating benign airway obstruction over a 10-year period in patients with inoperable lesions.
- 83% of patients experienced immediate symptom relief after placement of the stents, which were mostly in the trachea.
- However, complications were common, with 77% experiencing late issues, mainly due to stent migration, fracture, or granulomas, leading to clinical significance in 37% of cases.
- Overall, the findings suggest that while SEMAS can improve the quality of life for patients with major medical issues, there are considerable risks associated with their use.
Article Abstract
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.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386774 | PMC |
| http://dx.doi.org/10.1186/1471-2466-8-7 | DOI Listing |
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