Benign tracheobronchial stenoses: long-term clinical experience with balloon dilation.
OBJECTIVE
To assess the safety and long-term efficacy of balloon dilation in the treatment of benign tracheobronchial stenosis.


METHODS
Balloon dilation was performed under fluoroscopic guidance in 59 consecutive patients with benign tracheobronchial stenosis. Most patients had tuberculosis (48 of 59, 81%). Two to three serial balloon insufflations were performed for 5-180 seconds (mean, 85 sec) with inflation pressures as high as 16 atm with use of 6-20-mm-diameter balloon catheters. Patients with clinical evidence of restenosis underwent repeat balloon dilation. Patients were followed for 12-42 months (mean, 32 mo).


RESULTS
A total of 101 balloon dilation sessions were performed in 59 patients, with a range of one to four sessions per patient (mean, 1.7 sessions). Initial symptomatic improvement was achieved in 49 (83%) of the 59 patients; however, during the follow-up period, 39 (80%) of the 49 patients experienced recurrence of their symptoms. The primary patency rates at 3, 6, 9, 12, 18, 24, and 32 months were 92%, 60%, 45%, 24%, 20%, 20%, and 20%, respectively. The secondary patency rates at 3, 6, 9, 12, 18, 24, and 32 months were 92%, 87%, 75%, 43%, 43%, 43%, and 43%, respectively. Procedure-related major complications of deep mucosal laceration (n = 2) and bronchospasm (n = 1) occurred in three patients, but they experienced no subsequent problems.


CONCLUSIONS
Although the recurrence rate is high during the long-term follow-up period, balloon dilation seems to be a safe primary treatment modality for benign tracheobronchial stenoses and has an acceptable secondary patency rate.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001982:Bronchial Diseases / Q000628:therapy*; D001986:Bronchial Spasm / Q000209:etiology; D002404:Catheterization / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D022125:Lacerations / Q000209:etiology; D008297:Male; D008478:Mediastinal Emphysema / Q000209:etiology; D008875:Middle Aged; D012008:Recurrence; D012449:Safety; D013997:Time Factors; D014135:Tracheal Stenosis / Q000628:therapy*; D016896:Treatment Outcome