Efficacy and complications of the Gianturco-Z tracheobronchial stent for malignant airway stenosis.
OBJECTIVE
To describe our experience using the Gianturco Z-stent (G-Z stent) for the management of malignant tracheobronchial stenosis, with special reference to complications.


METHODS
Thirty-six stents were used in 22 patients with 28 lesions. Thirteen patients were grade 5 according to the Hugh-Jones classification. The technical success rates, follow-up results, and complications were reviewed on the basis of the patients' charts and radiographs.


RESULTS
All stents were successfully placed in the ideal position without procedure-related complications. After the procedure, respiratory status improved in 95% (21/22) of patients, and performance status improved in 77% (17/22). Mean survival after stent placement was 15 weeks. Four patients suffered from increased thick secretions requiring multiple suctioning and aspiration by bronchoscopy. One of these patients died from asphyxiation 2 weeks after placement. Stent disruption and/or migration was observed in six patients. Of these six, four experienced life-threatening hemoptysis; all four had received aggressive anticancer treatment.


CONCLUSIONS
G-Z stents are useful for palliation of malignant tracheobronchial obstruction. However, complications of stent strut fracture and migration give cause for concern.
Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki City, 216-8511 Japan.
Y
Y
Nakajima
Y
Y
Kurihara
H
H
Niimi
S
S
Konno
T
T
Ishikawa
H
H
Osada
H
H
Kojima
D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001980:Bronchi / Q000601:surgery*; D001999:Bronchoscopy; D002277:Carcinoma / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D002283:Carcinoma, Bronchogenic / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D004938:Esophageal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011474:Prosthesis Design; D011475:Prosthesis Failure; D013902:Radiography, Thoracic; D015607:Stents; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality; D014132:Trachea / Q000601:surgery*