title: Management of tracheal obstruction caused by benign or malignant thyroid disease using covered retrievable self-expandable nitinol stents.
abstract: BACKGROUND
  Curative resection is often contraindicated in patients with airway obstruction by aggressive thyroid disease.
  
  
  OBJECTIVE
  To evaluate the safety and clinical effectiveness of covered retrievable self-expandable nitinol stents placed in patients with airway obstruction caused by benign or malignant thyroid disease.
  
  
  METHODS
  From 1996 to 2009, covered retrievable self-expandable nitinol stents were placed in nine symptomatic patients with malignant (n=7) or benign (n=2) thyroid disease. Improvement in patient respiratory status, complications and their management, and survival data were evaluated. Stents were removed if stent-related complications occurred or the stents were no longer necessary.
  
  
  RESULTS
  A total of 11 stents were successfully placed without procedure-related complications. Improvement of more than one dyspnea grade was seen in eight of nine patients (89%), while the ninth patient underwent intubation due to upper airway swelling. Stent migration, sputum retention, and tumor overgrowth occurred in 27.3% (n=3), 9.1% (n=1), and 9.1% (n=1) of the stents, respectively. A total of six stents were successfully removed because of stent-related complications (n=4) or after total thyroidectomy (n=2). In two patients with benign thyroid goiters, a stable airway was maintained until total thyroidectomy.
  
  
  CONCLUSIONS
  Placement of covered retrievable self-expandable nitinol stents was safe and effective in patients with airway obstruction caused by benign or malignant thyroid disease. Stent retrievability was very useful in cases of stent-related complications. In patients with benign thyroid disease, stent placement can serve as an effective bridge to surgery.
authors: Department of Internal Medicine, Chuncheon Armed Forces Hospital, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors: Won-Kyeong
authors: WK
authors: Kim
authors: Ji Hoon
authors: JH
authors: Shin
authors: Jin Hyoung
authors: JH
authors: Kim
authors: Jin Woo
authors: JW
authors: Song
authors: Ho-Young
authors: HY
authors: Song
mesh_terms: D000328:Adult; D000368:Aged; D000497:Alloys; D001999:Bronchoscopy; D020099:Coated Materials, Biocompatible; D020878:Device Removal; D005260:Female; D005548:Foreign-Body Migration / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects; D013959:Thyroid Diseases / Q000150:complications* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000150:complications / Q000601:surgery; D013965:Thyroidectomy; D014135:Tracheal Stenosis / Q000209:etiology* / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000497:Alloys; D020099:Coated Materials, Biocompatible; C013616:nitinol