title: Tuberculous Tracheobronchial Strictures Treated with Balloon Dilation: A Single-Center Experience in 113 Patients during a 17-year Period.
abstract: OBJECTIVE
  To evaluate the safety and effectiveness of balloon dilation in the treatment of tuberculous tracheobronchial strictures (TTBSs) in a series of 113 patients at a single institution.
  
  
  METHODS
  The institutional review board approved the study and waived the requirement to obtain informed consent. Between 1997 and 2014, under bronchoscopic and fluoroscopic guidance, a total of 167 balloon dilation sessions were performed in 113 consecutive patients (14 male and 99 female patients; mean age, 37 years [age range, 17-73 years]), with a range of one to eight sessions per patient (mean, 1.5 sessions). Outcomes were number and/or frequency of balloon dilations, technical success, primary and secondary clinical success, improvement in respiratory status, airway patency rate, and alternative treatment after balloon dilation. A two-tailed paired t test and the Kaplan-Meier method were used to evaluate the improvement in respiratory status and airway patency rate after balloon dilation, respectively.
  
  
  RESULTS
  Dilation was successful in 82 patients (73%) after single (n = 67) or multiple (n = 15) balloon dilations, with a mean follow-up of 30.3 months. Clinical failure occurred in 31 patients (27%). In these 31 patients, symptoms recurred 1 day to 113 months (mean, 13 months) after repeat balloon dilations. These 31 patients required alternative treatment, including temporary stent placement (n = 12), cutting balloon dilation (n = 12), radiation-eluting balloon dilation (n = 3), and surgery (n = 4). Before, immediately after, and 1 month after the procedure, pulmonary function test results showed significant improvements in mean forced vital capacity (P < .001), forced expiratory volume in 1 second (P = .001), forced expiratory flow in the midexpiratory phase (P = .020), and peak expiratory flow (P = .005).
  
  
  CONCLUSIONS
  Balloon dilation of TTBSs is a safe, minimally invasive primary treatment that relieved symptoms in a large percentage of patients (73%). In patients with TTBSs refractory to balloon dilation, temporary stent placement, cutting balloon dilation, or radiation-eluting balloon dilation can be an alternative treatment.
authors.affiliation: From the Department of Radiology and Research Institute of Radiology (Y.C.C., J.H.K., J.H.P., J.H.S., H.K.K., H.Y.S.) and Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.M.C., T.S.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 138-736, Korea.
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Cho
authors.affiliation: From the Department of Radiology and Research Institute of Radiology (Y.C.C., J.H.K., J.H.P., J.H.S., H.K.K., H.Y.S.) and Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.M.C., T.S.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 138-736, Korea.
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kim
authors.affiliation: From the Department of Radiology and Research Institute of Radiology (Y.C.C., J.H.K., J.H.P., J.H.S., H.K.K., H.Y.S.) and Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.M.C., T.S.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 138-736, Korea.
authors.forename: Jung-Hoon
authors.initials: JH
authors.lastname: Park
authors.affiliation: From the Department of Radiology and Research Institute of Radiology (Y.C.C., J.H.K., J.H.P., J.H.S., H.K.K., H.Y.S.) and Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.M.C., T.S.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 138-736, Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Shin
authors.affiliation: From the Department of Radiology and Research Institute of Radiology (Y.C.C., J.H.K., J.H.P., J.H.S., H.K.K., H.Y.S.) and Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.M.C., T.S.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 138-736, Korea.
authors.forename: Heung Kyu
authors.initials: HK
authors.lastname: Ko
authors.affiliation: From the Department of Radiology and Research Institute of Radiology (Y.C.C., J.H.K., J.H.P., J.H.S., H.K.K., H.Y.S.) and Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.M.C., T.S.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 138-736, Korea.
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song
authors.affiliation: From the Department of Radiology and Research Institute of Radiology (Y.C.C., J.H.K., J.H.P., J.H.S., H.K.K., H.Y.S.) and Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.M.C., T.S.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 138-736, Korea.
authors.forename: Chang-Min
authors.initials: CM
authors.lastname: Choi
authors.affiliation: From the Department of Radiology and Research Institute of Radiology (Y.C.C., J.H.K., J.H.P., J.H.S., H.K.K., H.Y.S.) and Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (C.M.C., T.S.S.), Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul 138-736, Korea.
authors.forename: Tae Sun
authors.initials: TS
authors.lastname: Shim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001982:Bronchial Diseases / Q000209:etiology / Q000628:therapy*; D003251:Constriction, Pathologic; D004106:Dilatation / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014133:Tracheal Diseases / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications; D055815:Young Adult