PMID: 9436545Jan 22, 1998Paper

Airway simulation to guide stent placement for tracheobronchial obstruction in lung cancer

The Annals of Thoracic Surgery
Joseph ZwischenbergerR J Morrison

Abstract

To effectively palliate large airway obstruction in advanced unresectable lung cancer (stage IIIB or IV), we developed an airway imaging technique to guide selective endobronchial metallic stent placement. Fourteen consecutive patients with severe dyspnea (American Thoracic Society grade 4) had a combination of fiberoptic bronchoscopy, chest roentgenography, computed tomographic scanning, helical computed tomography with three-dimensional reconstruction, and intraluminal bronchography with selective bronchial guidewire placement under fluoroscopy to visually reconstruct and simulate the abnormal airway before and during stent placement. Wallstent or Gianturco intraluminal stents were used alone or in combination (up to five stents) to establish patency of the distal trachea and the major bronchi. All 14 patients had successful deployment with initial relief of airway stenosis (>75% predicted diameter). No procedural complications were noted. However, technical problems included stent foreshortening and imprecision of placement, misinterpretation of bronchography (mucous versus tumor), and airway maintenance during manipulation. Length of stay attributable to the procedure averaged 4 days. Stent placement initially improved the ...Continue Reading

References

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Citations

Jul 23, 1999·Cardiovascular and Interventional Radiology·Y NakajimaH Kojima
May 26, 2005·European Journal of Radiology·Eric M Walser
Apr 14, 1999·Respirology : Official Journal of the Asian Pacific Society of Respirology·H Kim
Apr 17, 1999·Clinics in Chest Medicine·M Ahmad, R A Dweik
Aug 2, 2007·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Kristin A KuceraJoseph B Zwischenberger

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