title: Long-term follow-up and survival after Ultraflex stent insertion in the management of complex malignant airway stenoses.
abstract: BACKGROUND
  Despite being commercially available for a few years now, the literature regarding the outcome of Ultraflex stent insertion in complex malignant airway stenoses is sparse.
  
  
  OBJECTIVE
  To assess long-term complications and survival in patients with complex malignant airway stenoses treated with insertion of nitinol stents.
  
  
  METHODS
  60 consecutive patients with Ultraflex stent insertion for malignant airway stenoses were included. Follow-up was obtained in all patients.
  
  
  RESULTS
  62 Ultraflex stents (covered = 51, uncovered = 11) were implanted in 60 patients. Diagnoses were bronchial carcinoma (n = 50), esophageal carcinoma (n = 3) and metastases (n = 7). Stents were inserted in the trachea (n = 5), main bronchi/intermediate bronchus (n = 22), from main bronchi/intermediate bronchus to lobar bronchi (n = 28) or in the lobar bronchi themselves (n = 7). Successful reopening of the stenoses and relief were achieved in all patients. There was no procedure-related mortality. Complications included mucous plugging in 8%, stenosing granulation tissue in 5%, tumor ingrowth in 5% and stent migration in 5% of patients. Using Kaplan-Meier estimates, the overall mean survival was 160 days (standard error: 30). Median survival was 91 days. The overall 3- and 6-month survival were 52 and 20%, respectively. Death (n = 59, 98%) was attributed mainly to disease progression with cachexia and metastases, pneumonia (n = 5, 10%), and hemoptysis (n = 1, 2%).
  
  
  CONCLUSIONS
  Ultraflex stents have a low complication rate and can be effectively used in complex malignant airway stenoses with marked asymmetry or irregularity, angulation or changing diameters.
authors.affiliation: Department of Pulmonary Medicine, University Hospital Basel, Basel, Switzerland. albrecht.breitenbuecher@ksbh.ch
authors.forename: Albrecht
authors.initials: A
authors.lastname: Breitenbücher
authors.forename: Prashant N
authors.initials: PN
authors.lastname: Chhajed
authors.forename: Martin H
authors.initials: MH
authors.lastname: Brutsche
authors.forename: Carlo
authors.initials: C
authors.lastname: Mordasini
authors.forename: Daniel
authors.initials: D
authors.lastname: Schilter
authors.forename: Michael
authors.initials: M
authors.lastname: Tamm
mesh_terms: D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy*; D000497:Alloys; D001984:Bronchial Neoplasms / Q000150:complications; D002277:Carcinoma / Q000150:complications; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D016019:Survival Analysis
chemical_list: D000497:Alloys; C013616:nitinol