title: Treatment of benign and malignant tracheobronchial obstruction with metal wire stents: experience with a balloon-expandable and a self-expandable stent type.
abstract: Over the last few years various types of metal wire stents have been increasingly employed in the treatment of both malignant and benign tracheobronchial obstruction. To date, however, few studies have investigated the in vivo properties of different stent types. We implanted 26 balloon-expandable tantalum Strecker stents (18 patients) and 18 self-expandable Wallstents (16 patients) into the tracheobronchial system of 30 patients with combined stenting in 4 patients. Mean age was 51 years (range: 0.5-79 years). Malignant disease was present in 23 patients, benign disease in seven patients. Both patients and individual stents were monitored clinically and radiographically. The probability of stents remaining within the tracheobronchial system, and of their remaining undislocated and uncompressed was calculated using Kaplan-Meier analysis for both stent types. Average stent follow-up time was 112 days until explantation and 115 days until patients' death or discharge. Kaplan-Meier analysis revealed a higher probability for the Wallstent to remain within the tracheobronchial system. Dislocation and compression occurred more rarely. Explantation, however, if desired, was more difficult compared to the Strecker stent. The Wallstent also led to the formation of granulation tissue, especially at the proximal stent end, frequently requiring reintervention. Both stent types proved to be effective therapeutic options in the management of obstructive tracheobronchial disease. The mechanical properties of the Strecker stent seem to be less favorable compared to the Wallstent but removal is easy. For benign disease, however, the Wallstent reveals limitations due to significant side effects.
authors.affiliation: Department of Clinical Radiology, University Hospitals of the Ludwig-Maximilians-University, Munich Ziemssenstr. 1, 80336, München, Germany. jrieger@ikra.med.uni-muenchen.de
authors.forename: Johannes
authors.initials: J
authors.lastname: Rieger
authors.forename: Hubert
authors.initials: H
authors.lastname: Hautmann
authors.forename: Ulrich
authors.initials: U
authors.lastname: Linsenmaier
authors.forename: Cristoph
authors.initials: C
authors.lastname: Weber
authors.forename: Markus
authors.initials: M
authors.lastname: Treitl
authors.forename: Rudolf Maria
authors.initials: RM
authors.lastname: Huber
authors.forename: Klaus-Jürgen
authors.initials: KJ
authors.lastname: Pfeifer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001982:Bronchial Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012142:Respiratory Tract Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D012208:Rhabdomyosarcoma / Q000150:complications / Q000000981:diagnostic imaging; D015607:Stents; D014057:Tomography, X-Ray Computed; D014135:Tracheal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*