title: Our Experience on Silicone Y-Stent for Severe COPD Complicated With Expiratory Central Airway Collapse.
abstract: BACKGROUND
  Expiratory central airway collapse (ECAC) is abnormal central airway narrowing during expiration. ECAC involves 2 different pathophysiological entities as tracheobronchomalacia and excessive dynamic airway collapse (EDAC). Although the exact cause is unknown, chronic obstructive pulmonary disease (COPD) is frequently accompanied by ECAC. Although there are various publications on the relationship between COPD and ECAC, there are very few data for stent placement in patients with tracheobronchomalacia accompanied severe COPD. We share our results for stenting in ECAC among patients with severe COPD.
  
  
  METHODS
  The data in this case series were collected retrospectively. The ECAC diagnosis was made during flexible bronchoscopy with severe COPD. Silicone Y-stents were placed via rigid bronchoscopy under general anesthesia.
  
  
  RESULTS
  A total of 9 patients' (7 men) data were evaluated with an average age of 67±10.73 years. One patient experienced stent migration on the second day of stenting prompting stent removal. Another patient died 1 month after stenting. Consequently, we evaluated the follow-up data of remaining 7 patients. The changes in forced expiratory volume 1 was not significant for these 7 cases (P=0.51). The modified Medical Research Council (mMRC) score improvement was statistically significant (P=0.03). Functional status improvement was observed in 4 of 7 patients. Of the 7 patients, mean additional follow-up bronchoscopic interventions requirement was 2.2 times.
  
  
  CONCLUSIONS
  Our study showed significant decrease in mMRC score with stenting for ECAC in severe COPD. For 2 patients, we experienced severe complications during short-term follow-up period after stenting. Additional follow-up bronchoscopic interventions were required.
authors.affiliation: *Department of Pulmonary Medicine, Yedikule Education and Research Hospital for Chest Diseases and Thoracic Surgery‡Department of Chest Disease, Koc University Faculty of Medicine§Department of Chest Diseases, Bagcilar Education and Research Hospital, İstanbul†Department of Chest Diseases, Karabuk University Faculty of Medicine, Karabuk∥Department of Chest Diseases, Merzifon Karamustafa Paşa State Hospital, Amasya, Turkey¶Department of Pulmonary and Critical Care, University of Minnesota, Minneapolis, MN.
authors.forename: Mehmet A
authors.initials: MA
authors.lastname: Ozgul
authors.forename: Erdogan
authors.initials: E
authors.lastname: Cetinkaya
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cortuk
authors.forename: Sinem
authors.initials: S
authors.lastname: Iliaz
authors.forename: Elif
authors.initials: E
authors.lastname: Tanriverdi
authors.forename: Sule
authors.initials: S
authors.lastname: Gul
authors.forename: Guler
authors.initials: G
authors.lastname: Ozgul
authors.forename: Hilal
authors.initials: H
authors.lastname: Onaran
authors.forename: Kenan
authors.initials: K
authors.lastname: Abbasli
authors.forename: Huseyin E
authors.initials: HE
authors.lastname: Dincer
mesh_terms: D000368:Aged; D001982:Bronchial Diseases / Q000503:physiopathology / Q000601:surgery; D001999:Bronchoscopy / Q000379:methods; D020878:Device Removal; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011475:Prosthesis Failure; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012828:Silicones; D015607:Stents; D055089:Tracheobronchomalacia / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D012828:Silicones