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Airway stents provide symptomatic relief
  1. P Macedo
  1. Ealing Hospital, UK; patmacdoctors.org.uk

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This paper reports the indications, techniques, and results of tracheobronchial stenting in the authors’ unit. One hundred and forty three patients underwent 309 stent procedures between May 1992 and December 2001. Malignancy was the most common indication (67% of cases). The main symptoms were dyspnoea, respiratory distress, and stridor. 82% of patients required emergency procedures as most (77%) had more than 75% narrowing of the airway. All patients underwent rigid bronchoscopies except two who had flexible bronchoscopies for insertion of expandable metal stents. 87% of stents placed were silicone rubber. 27% of patients had primarily a tracheal obstruction but in 49% multiple sites were involved.15% required multiple stents and 68% had a bronchoscopic intervention (core out, dilatation, brachytherapy, laser or photodynamic therapy) in preparation or as an adjunct to stenting. Significant improvement was reported in 95% of patients; 41% required multiple bronchoscopies to maintain this improvement. Complications from stenting occurred in 41% of cases—namely, stent migration, partial occlusion of stent by secretions, and partial obstruction by granulations. Perforation occurred in four patients but only one required thoracotomy. 28 % of patients with malignancy required further intervention to maintain airway patency (mean airway palliation 4 months). 45% of patients with malignant disease and 17% with benign disease had no follow up data available following the original intervention.

This paper shows that stenting can produce immediate symptomatic improvement in unresectable patients but multiple stents and procedures are frequently required.

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