Palliative airway stenting performed under radiological guidance and local anesthesia.
OBJECTIVE
To assess the effectiveness of airway stenting performed exclusively under radiological guidance for the palliation of malignant tracheobronchial strictures.


METHODS
We report our experience in 16 patients with malignant tracheobronchial stricture treated by insertion of 20 Ultraflex self-expandable metal stents performed under fluoroscopic guidance only. Three patients presented dysphagia grade IV due to esophageal malignant infiltration; they therefore underwent combined airway and esophageal stenting. All the procedures were performed under conscious sedation in the radiological room; average procedure time was around 10 min, but the airway impediment never lasted more than 40 sec.


RESULTS
We obtained an overall technical success in 16 cases (100%) and clinical success in 14 patients (88%). All prostheses were successfully placed without procedural complications. Rapid clinical improvement with symptom relief and normalization of respiratory function was obtained in 14 cases. Two patients died within 48 hr from causes unrelated to stent placement. Two cases (13%) of migration were observed; they were successfully treated with another stent. Tumor overgrowth developed in other 2 patients (13%); however, no further treatment was possible because of extensive laryngeal infiltration.


CONCLUSIONS
Tracheobronchial recanalization with self-expandable metal stents is a safe and effective palliative treatment for malignant strictures. Airway stenting performed exclusively under fluoroscopic view was rapid and well tolerated.
Profili
Stefano
S
Department of Radiology, University of Sassari, Sassari, Italy.
Manca
Antonio
A
Feo
Claudio F
CF
Padua
Guglielmo
G
Ortu
Riccardo
R
Canalis
Giulio C
GC
Meloni
Giovanni B
GB
D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D001982:Bronchial Diseases / Q000601:surgery*; D016292:Procedural Sedation / Q000379:methods; D004947:Esophagus / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D015607:Stents / Q000009:adverse effects; D014057:Tomography, X-Ray Computed / Q000379:methods; D014132:Trachea / Q000000981:diagnostic imaging*; D014135:Tracheal Stenosis / Q000601:surgery*; D016896:Treatment Outcome