• Metallic stent
• Silicone stent
• Tracheal stent
• Tracheoesophageal fistula

• Humans
• Male
• Retrospective Studies
• Female
• Tracheoesophageal Fistula/surgery
• Middle Aged
• Silicones
• Stents/adverse effects
• Aged
• Adult
• Bronchoscopy
• Treatment Outcome
• Postoperative Complications/etiology
• Postoperative Complications/epidemiology
• Metals

• Y‐metal stents (SEMS)
• airway obstruction
• flexible bronchoscopy
• mediastinal tumors
• rigid bronchoscopy

• Università degli Studi della Campania Luigi Vanvitelli

• airway stenting
• complications
• malignant central airway obstruction
• mechanical ventilation
• mortality
• quality of life
• surveillance

• Humans
• Stents
• Lung Neoplasms/complications
• Airway Obstruction/therapy
• Airway Obstruction/etiology
• Bronchoscopy/methods
• Pulmonary Medicine/standards
• Societies, Medical

• 3D printing
• biodegradable airway stent
• customized prosthesis
• finite element method
• parametric model
• polylactic acid

• PID2021-125731OB-C31 Spanish Ministry of Science and Innovation MCIN/AEI/10.13039/501100011033/
• PID2021-125731OB-C32 Spanish Ministry of Science and Innovation MCIN/AEI/10.13039/501100011033/
• PID2021-125731OB-C33 Spanish Ministry of Science and Innovation MCIN/AEI/10.13039/501100011033/

• Airway stenosis
• education
• intervention
• stent
• tracheoesophageal fistula

• Malignant airway obstruction
• Radionuclide
• Rigid bronchoscopy
• Safety and efficacy
• Y-shape sigma

• Humans
• Bronchoscopy/methods
• Airway Obstruction/therapy
• Male
• Female
• Aged
• Middle Aged
• Stents
• Palliative Care/methods
• Lung Neoplasms/complications
• Karnofsky Performance Status
• Aged, 80 and over
• Treatment Outcome
• Brachytherapy/methods
• Brachytherapy/adverse effects
• Adult
• Iodine Radioisotopes

• Aspergillosis
• Bronchiectasis
• Chronic obstructive pulmonary disease
• Tuberculosis

• Humans
• Tuberculosis, Pulmonary/complications
• Tuberculosis, Pulmonary/diagnosis
• Tuberculosis, Pulmonary/drug therapy
• Constriction, Pathologic
• Lung Diseases
• Chronic Disease
• Tuberculosis/complications
• Aspergillosis/complications

• 2022E200100 Korea National Institute of Health

• adenoid cystic carcinoma
• temporary stenting
• tracheal stenosis

• Humans
• Quality of Life
• Treatment Outcome
• Stents
• Retrospective Studies
• Airway Obstruction/surgery

The insertion of self-expandable metallic stents (SEMS) for post-tuberculosis tracheobronchial stenosis (PTTS) was controversial. This study aimed to evaluate the efficacy and safety of SEMS for treating PTTS, and developed a scoring system for predicting the occurrence of restenosis after stenting in PTTS patients.

We conducted a retrospective review of 87 patients who were diagnosed with PTTS and experienced SEMS insertion between January 2000 and December 2017. All procedures were performed via flexible bronchoscopy under conscious sedation and local anesthesia.

A total of 85 SEMS were successfully placed in 77 patients. Comparing with pre-stenting, there were significant improvements in the lumen diameters of the stenotic segment, mMRC scale and lung function after short-term SEMS placement. During the long-term (average 163.32 months) follow-up, 48 patients (62.3%) did not develop restenosis after stenting; the other 29 patients (37.7%) developed and eventually, 12 remained under interventional therapies and 11 had bronchial atresia. Multivariate Cox regression analysis revealed that the difference value between SEMS length and the stenosis-segment length, stenosis type, and the number of pre-stenting thermal ablation were independently related to restenosis occurrence and were subsequently used to establish the Restenosis Score. The model’s development group (0.83, 95% CI 0.74–0.92) and external validation set (0.94, 95% CI 0.77–1.00) showed excellent discrimination.

SEMS placement could serve as a safe and effective treatment option for most patients with PTTS. Further, we built a prediction model depending on the independent predictors of restenosis occurrence, the Restenosis Score. This validated tool might provide a decision support and a better management for PTTS patients who underwent SEMS implantation.

• Airway stenosis
• Prediction
• Restenosis
• Self-expandable metallic stents
• Tuberculosis

Tracheal stenosis is a life-threatening condition, and management of a patient with a risk of tracheal stenosis is challenging for anesthesiologists. In this report, we describe a method for airway management using two gum elastic bougie method when removing a tracheal stent via a tracheostomy orifice with a risk of airway restenosis.

A 71-year-old man had an enlarged squamous cell carcinoma of the lung invading the upper mediastinum that had caused severe stenosis of the trachea. Two months after diagnosis, a tracheal stent had been placed to maintain tracheal patency. One month after stent placement, acute respiratory failure was induced by upper airway obstruction caused by subglottic airway edema due to mechanical stimulation of the cranial end of the stent, and the patient was rescued by oral tracheal intubation. Tracheal stent extraction was scheduled to relieve the laryngeal edema. Since there was a risk of tracheal restenosis because of the possibility of accidental evulsion of the orally tracheal tube which intubated to secure an emergency airway and tracheal stent extraction, two gum elastic bougies were inserted through the oral tracheal tube and tracheostomy orifice to facilitate re-intubation. After extraction of the tracheal stent, airway openness was maintained and tracheostomy was completed without any complication.

Successful management of tracheal stent extraction was performed using a double gum elastic bougie technique.

• Airway obstruction
• Self-expandable metallic stent
• Tracheal stenosis
• Tracheostomy

• Removal
• Stent
• Tracheal
• Tubular

• Fluoroscopy
• Postoperative complications
• Respiratory tract fistula
• Stents removal
• Tracheal stenosis

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Device Removal/methods
• Duration of Therapy
• Female
• Fluoroscopy
• Humans
• Male
• Middle Aged
• Postoperative Complications
• Recurrence
• Respiratory Tract Fistula/therapy
• Retrospective Studies
• Stents
• Tracheal Diseases/therapy
• Tracheal Stenosis/therapy
• Young Adult

• 81501569 National Natural Science Foundation of China

• Tracheobronchial stents
• biodegradable stents
• fluoroscopy
• interventional pulmonology
• rigid bronchoscopy

• bronchoscopy
• chronic bronchitis
• emphysema
• lung cancer

• benign tracheobronchial stenosis
• metallic stent
• silicone stent

• Adult
• Bronchi/abnormalities
• Bronchi/surgery
• Constriction, Pathologic/surgery
• Female
• Humans
• Male
• Middle Aged
• Republic of Korea
• Retrospective Studies
• Stents/adverse effects
• Stents/standards
• Stents/trends
• Trachea/abnormalities
• Trachea/surgery
• Treatment Outcome

• animal model
• pediatrics
• removable
• stent
• tracheomalacia

• Airway stent placement
• Intervention room
• Operating room

• Aged
• Aged, 80 and over
• Bronchial Diseases/diagnostic imaging
• Bronchial Diseases/therapy
• Constriction, Pathologic
• Esophageal Neoplasms/complications
• Female
• Humans
• Lung Neoplasms/complications
• Male
• Middle Aged
• Retrospective Studies
• Self Expandable Metallic Stents
• Tomography, X-Ray Computed
• Tracheal Stenosis/diagnostic imaging
• Tracheal Stenosis/therapy

• Airway obstruction
• Airway stent
• Rigid bronchoscopy

• children
• complication
• follow-up
• metal stent
• tracheal stenosis

• airway stenosis
• airway stent
• complications
• fluoroscopy
• stent removal

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Bronchial Diseases/therapy
• Child
• Device Removal/methods
• Device Removal/mortality
• Female
• Fluoroscopy
• Humans
• Male
• Middle Aged
• Radiography, Interventional/mortality
• Stents
• Tracheal Stenosis/therapy
• Young Adult

Self-expanding metals stent are used for recanalization of malignant CAO. Fracture of such a stent has been described. This prompts its removal. However removal of a metal stent is difficult and can be hazardous. Due to this US FDA advisory was released against their insertion in benign diseases where long life expectancy can expose the patients to the complications of prolonged indwelling time of these stents. We describe a case of adenoid cystic carcinoma who required SEMS placement for tracheal obstruction. However, stent fracture developed soon after its insertion causing patient to cough out stent pieces multiple times. In view of the challenge associated with removal of metal stent fixed to the tracheal walls at its proximal and distal ends, the stent was left in-situ. Patient has tolerated the fractured stent for 1-year and remains on follow-up without any complication or adverse event. This illustrates the long-term tolerance and safety of a fractured stent and helps to allay anxiety associated with this complication.

• Adenoid cystic carcinoma
• Bronchoscopy
• Cancer
• Self-expanding metal stent
• Stent fracture

Canine tracheal collapse is a complex airway pathology without promising treatment results. Currently nitinol stents are the best surgical option; however, some professionals are doubting if stent placement is the best option due to the associated complications.

Determine the technical feasibility, safety, and long-term follow-up after the implantation of a new tracheal stent designed for canine tracheal collapse.

Thirteen healthy, adult female New Zealander rabbits were involved in this pilot study.A new intra-tracheal device (Reference number 902711 patent registered as CasMin-Twine) was implanted in ten animals. Deployment was performed under general anesthesia, making a puncture incision via a 21 Gauge needle in the intra-tracheal space where the stent was introduced with a screwing process. The device was fixed to the tracheal wall with a non-absorbable suture. Computerized Tomography (CT) and an endoscopy to study structural abnormalities were performed after 30, 90 and 365 days after stent placement.

Technical and clinical success was 100%. There was no significant change in behavior or respiratory disorders. CT studies showed no significant alterations. After the 30 days, 60% of the animals showed partial endothelization in the endoscopy study, and only one animal still presented partial endothelization after 12 months. Mucus accumulation was only present in 40% of cases and classified as low, without respiratory consequences. Only one animal presented a single granuloma at caudal stent tip.

This new tracheal stent (CasMin-Twine) is an effective and safe procedure with promising results, and also shows the possibility of removing the device after endothelization has been produced. New studies should be carried out to evaluate the effectiveness in patients with tracheomalacia.

This new product can give veterinarians a new option of treatment for this complicated pathology. Minimizing specific equipment for its deployment, CasMin-Twine will be more accessible for all professionals.

• Airway management
• Device removal
• Dogs
• Interventional radiology
• Minimally invasive surgical procedures
• Pilot study
• Respiratory pathology
• Stent
• Tracheal collapse
• Tracheomalacia

• airway obstruction
• chemotherapy
• interventional bronchoscopy
• lung cancer

• Aged
• Airway Obstruction/etiology
• Airway Obstruction/surgery
• Antineoplastic Agents, Phytogenic/administration & dosage
• Bronchoscopy
• Carcinoma, Non-Small-Cell Lung/drug therapy
• Carcinoma, Non-Small-Cell Lung/pathology
• Feasibility Studies
• Female
• Humans
• Injections, Intralesional
• Lung Neoplasms/drug therapy
• Lung Neoplasms/pathology
• Male
• Middle Aged
• Paclitaxel/administration & dosage
• Prospective Studies
• Quality of Life
• Stents
• Treatment Outcome

• R42 CA141907 NCI NIH HHS
• T32 HL007534 NHLBI NIH HHS

Malignant endobronchial mass (MEM) has poor prognosis, cryotherapy is reportedly to diagnose MEM, however, the therapeutic role of cryotherapy impacts on survival has not be well addressed.

Cohort data on post-cryotherapy MEM patients in a university-affiliated hospital between 2007 and 2012 were evaluated. Factors that impact survival of these subjects were analyzed using multivariate regression analysis.

During study period, 67 patients (47 males), with median age was 63 years (range, 50–77 and median performance status of 2 (inter-quartile range [IQR], 2–3). Twenty-five had primary lung squamous cell carcinoma, 14 primary had lung adenocarcinoma, seven had metastatic colon adenocarcinoma, four had sarcoma, four had non-small cell lung cancer, four had small cell lung cancer, three had large cell carcinoma, two had lymphoma, one had muco-epidermoid carcinoma, two had esophageal squamous cell carcinoma, and one had metastatic renal cell carcinoma. MEM were observed as follows: 15 at the trachea, 14 at the left main bronchus, 12 at the right main bronchus, 12 at the right upper lobe bronchus, five at the right intermediate bronchus, three at the right lower lobe bronchus, three at the left upper lobe bronchus, two at the left lower lobe bronchus, and one at the right middle lobe bronchus Post-cryotherapy complications included minor bleeding (n = 14) and need for multiple procedures (n = 12); outcomes were relief of symptoms (n = 56), improved performance status (n = 49) and ability to receive chemotherapy (n = 43). After controlling for other variables, performance status improved after cryotherapy (odds ratio [OR] 3.7; p = 0.03; 95% confidence interval [CI] 1.2~10.7) and ability to receive chemotherapy (OR 4.3; p = 0.02; 95% CI 1.4~13.7) remained significant survival factor. Patients who received chemotherapy and cryotherapy had better survival than patients who received only cryotherapy (median, 472 vs. 169 days; log-rank test, p = 0.02; HR 0.37; 95% CI 0.16–0.89).

Cryotherapy could be useful management of MEM by flexible bronchoscopy. The performance status after cryotherapy improved and caused further chemotherapy possible for the study patients and thereby, improved survival. However, the mechanism in detail of cryotherapy improve survival should be explored in the future.

• Chemotherapy
• Cohort
• Cryotherapy
• Malignant endobronchial mass
• Survival

Self-expandable metallic (SEM) airway stents are an important approach to malignant central airway obstruction (CAO). SEM airway stent insertions are usually performed under fluoroscopic guidance over a guide wire placed through a flexible bronchoscope often resulting in a longer procedure time and exposure to radiation. In this pilot study, we designed a novel delivery system of the through-the-scope (TTS) SEM airway stent insertion and observed its feasibility.

From Jan 2015 to Sept 2016, 25 consecutive patients with inoperable malignant CAO were enrolled requiring airway stent implantation. All patients were followed up to death or at least 6 months.

36 TTS stents were inserted into 25 patients using a flexible bronchoscope under general anesthesia or local anesthesia. All stents were successfully deployed directly through the working channel (2.8 mm diameter) of the flexible bronchoscope in 91.7% (33/36) of the subjects. The mMRC score and stenosis grade improved significantly after stent implantation. The common stent-related complications were secretion retention (25%, 9/36), development of granulation tissue (13.9%, 5/36), tumor in-growth (13.9%, 5/36), and hemoptysis (8.3%, 3/36). The 6-month overall survival (OS) was 44% (11/25).

The novel TTS stent release system was an effective and safe approach in malignant central airway obstruction.

• Airway stent
• Complications
• Fluoroscopy
• Post-intubation tracheal stenosis
• Post-tracheotomy tracheal stenosis

• Adolescent
• Adult
• Aged
• Child
• Device Removal/methods
• Female
• Fluoroscopy
• Humans
• Intubation, Intratracheal/adverse effects
• Male
• Middle Aged
• Postoperative Complications/etiology
• Postoperative Complications/surgery
• Prosthesis Design
• Retrospective Studies
• Stents
• Tracheal Stenosis/etiology
• Tracheal Stenosis/surgery
• Tracheotomy/adverse effects
• Young Adult

• 81501569 National Natural Science Foundation of China

• Airway stenting
• Benign tracheobronchial stenosis
• Self-expandable metallic stents

To evaluate the safety and efficacy of a novel radioactive bare metal stent (RBMS) compared with a conventional bare metal stent (CBMS) in patients with inoperable malignant airway obstruction.

This prospective study was approved by the Institutional Ethics Committee, and informed consent was obtained from each participant. Patients with malignant airway obstruction who had dyspnea were randomly assigned to receive RBMS or CBMS placement. The primary endpoint was stenosis grade, while the secondary endpoints were technical success, overall survival, and complications. A p value of <0·05 was considered statistically significant.

Between September 2013 and July 2015, 66 patients with inoperable malignant airway obstruction received stent placement fluoroscopically (33 in either group). The median follow-up time was 154 days (range, 15–335 days). The baseline stenosis was immediately relieved in both groups after stent placement, and the stenosis grades in the RBMS group were significantly lower than that in the CBMS group since the second month (p < 0·05). The technical success rates of stent placement were 100% in both groups. The median survival in the RBMS group was significantly longer than that in the CBMS group (170 days vs. 123 days, p < 0·05). There was no significant difference in the incidence of complications between the two groups (p < 0·05).

The placement of RBMS in patients with inoperable malignant airway obstruction is feasible and safe, and it significantly reduces restenosis and improves overall survival compared with the placement of CBMS.

•

The baseline stenosis was immediately relieved in both groups after stent placement.

Malignant airway obstruction (MAO) is a serious situation of 20-30% cases of lung cancer, resulting in dyspnea, decreased functional status, and asphyxiation risk. Conventional stent placement provides immediate palliation of dyspnea. However, stent restenosis occurs during the follow up. A novel radioactive bare metal stent (RBMS) loaded with ¹²⁵I seed was developed for preventing such restenosis. Our study showed that placement of RBMS in patients with inoperable malignant airway obstruction is feasible and safe, and it significantly reduces the restenosis and improves overall survival compared with placement of conventional stent.

• Intraluminal brachytherapy
• Malignant airway obstruction
• Restenosis
• Stent

• Bronchoscopy
• airway stent placement
• malignant airway lesions
• risk factors
• stent-related complications

• Self-expandable metallic stent (SEMS)
• bronchopleural fistula
• lung abscess
• medical thoracoscopy (MT)
• migration
• pleuroscopy

• Antiplatelet therapy
• bilateral self‐expandable metallic stents
• chemotherapy
• malignant main carinal involvement
• side‐by‐side method

• Interventional pulmonology
• confocal laser endomicroscopy
• electromagnetic navigation bronchoscopy
• endobronchial ultrasound
• laser Raman spectroscopy
• rigid bronchoscopy

• Biomechanical
• Finite element method
• Granulation
• Lung
• Nitinol
• Stenting
• Tracheobronchial

• Bronchoscopy
• Endoscopic ultrasound-guided fine needle aspiration
• Tracheobronchial stenosis
• Tuberculosis

• Bronchoalveolar Lavage
• Bronchoscopy/methods
• Endoscopic Ultrasound-Guided Fine Needle Aspiration
• Humans
• Lymph Nodes/pathology
• Mycobacterium tuberculosis
• Tuberculosis, Lymph Node/pathology
• Tuberculosis, Pulmonary/diagnosis
• Tuberculosis, Pulmonary/therapy

• Bronchoscopy
• complications
• stent
• surveillance

• airway obstruction
• airway stent
• tracheostomy

• Aged, 80 and over
• Airway Obstruction/etiology
• Humans
• Male
• Stents/adverse effects
• Tracheostomy/adverse effects

• Airway obstruction
• Bronchial asthma
• Bronchoscopy
• Chronic obstructive pulmonary disease
• Hemoptysis

• Bronchoscopes
• Bronchoscopy/instrumentation
• Bronchoscopy/methods
• Equipment Design
• Equipment Failure Analysis
• Evidence-Based Medicine
• Humans
• Lung Diseases/pathology
• Lung Diseases/surgery
• Minimally Invasive Surgical Procedures/instrumentation
• Minimally Invasive Surgical Procedures/methods
• Technology Assessment, Biomedical
• Treatment Outcome

• Interventional pulmonology
• lung cancer
• tracheo-bronchial malignancies
• tracheobronchial endoscopy
• treatment