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stent malignant airway obstruction

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https://read.qxmd.com/read/30776363/prospective-multicentered-safety-and-feasibility-pilot-for-endobronchial-intratumoral-chemotherapy
#1
Lonny Yarmus, Christopher Mallow, Jason Akulian, Cheng Ting Lin, David Ettinger, Russell Hales, Kinh Ranh Voong, Hans Lee, David Feller-Kopman, Roy Semaan, Kirk Seward, Momen M Wahidi
BACKGROUND: Malignant airway obstruction (MAO) occurs in 30% of patients with advanced stage lung cancer leading to debilitating dyspnea, cough and hemoptysis. Other than recanalization of the airways, these patients lack long-lasting palliative therapy. The goal of this study was to determine the safety and feasibility of local injection of paclitaxel into the airway wall with a novel microinjection catheter. METHODS: In this multicentered prospective trial, 23 patients with non-small cell lung cancer (NSCLC) and MAO from July 2014 through June 2016 were enrolled to undergo rigid bronchoscopy with recanalization, followed by injection of 1...
February 15, 2019: Chest
https://read.qxmd.com/read/30707169/comparison-of-clinical-features-and-stent-placement-outcomes-between-airway-stenosis-caused-by-primary-pulmonary-malignancies-and-that-caused-by-primary-non-pulmonary-malignancies
#2
Jin-Mu Niu, Jie Zhang, Xiao-Jian Qiu, Juan Wang, Ying-Hua Pei, Yu-Ling Wang, Ting Wang
BACKGROUND: Primary pulmonary malignancies (PPMs) and non-pulmonary malignancies (PNPMs) may result in airway stenosis requiring stenting. This study aimed to compare and evaluate the clinical features and stent placement outcomes of airway stenosis caused by PPMs and PNPMs. METHODS: A total of 141 patients with malignant airway stenosis who underwent Micro-Tech stent placements between January 2004 and October 2017 at Department of Respiratory Medicine, Beijing Tian Tan Hospital, Capital Medical University were divided into PPM (nā€Š=ā€Š100) and PNPM groups (nā€Š=ā€Š41)...
January 30, 2019: Chinese Medical Journal
https://read.qxmd.com/read/30555703/management-of-malignant-carinal-involvement-using-side-by-side-method-of-bilateral-self-expandable-metallic-stents
#3
Takayuki Takeda, Hideki Itano, Ryo Wakasa, Masahiko Saitoh, Sorou Takeda
Central airway obstruction caused by cancer requires urgent interventional pulmonology. Malignant main carinal involvement is one of the most challenging situations, usually treated by rigid bronchoscopic intervention under general anaesthesia. However, these patients tend to be in poor condition due to underlying malignancy. Therefore, less-invasive strategies are needed. Six patients with lung cancer exhibiting malignant carinal involvement treated using the 'side-by-side' method of bilateral self-expandable metallic stents using fibre-optic bronchoscopy under topical anaesthesia were retrospectively investigated...
February 2019: Respirology Case Reports
https://read.qxmd.com/read/30037444/rapid-fire-superior-vena-cava-syndrome
#4
REVIEW
Shelly Zimmerman, Matthew Davis
Superior vena cava syndrome occurs from obstruction of the superior vena cava. The most common cause is malignancy. Small cell lung cancer and non-Hodgkin lymphoma are the most frequent culprits. Intravascular devices associated with thrombus are becoming more common causes. Classic symptoms include edema, plethora, and distended veins of the face, neck, and chest; shortness of breath; cough; headache; and hoarseness. Treatment in the emergency department is mostly supportive, with head elevation, oxygen, and steroids...
August 2018: Emergency Medicine Clinics of North America
https://read.qxmd.com/read/29977763/new-hybrid-method-for-trachea-dilatation-with-rigid-and-flexible-tools
#5
Konstantinos Sapalidis, Stella Laskou, Aikaterini Amaniti, Charilaos Koulouris, Dimitrios Giannakidis, Stylianos Mantalovas, Ilias Karapantzos, Chrysa Karapantzou, Paul Zarogoulidis, Iakovos Arapakis, Haidong Huang, Chong Bai, Ioanna Kougioumtzi, Nikolaos Katsikogiannis, Eirini Sarika, Fotis Konstantinou, Wolfgang Hohenforst-Schmidt, Isaak Kesisoglou
Trachea stenosis is observed either in benign or malignant situations. In cancer malignancy a tumor might obstruct the central airway in three different ways. Again granuloma tissue is usually observed after intubation or stent placement in order to manage a benign malformation of the trachea. In any case there are several tools and techniques that can be used either with surgery or endoscopically to manage such situation. We will focus on a hybrid technique in order to ventilate the patient while performing endoscopic management of granuloma tissue...
2018: Respiratory Medicine Case Reports
https://read.qxmd.com/read/29914968/tracheobronchial-stents-in-palliative-care-a-case-series-and-literature-review
#6
Richard Tjahjono, Ronald Yoon-Kong Chin, Peter Flynn
OBJECTIVE: To evaluate the outcomes of tracheobronchial stenting in patients with malignant central airway obstruction and assist practitioners in palliative settings in understanding the indications, contraindications and management of tracheobronchial stents. METHODS: This retrospective study involved a consecutive case series of palliative patients with central airway obstruction secondary to inoperable cancers who underwent tracheobronchial stenting at a single institution...
September 2018: BMJ Supportive & Palliative Care
https://read.qxmd.com/read/29909977/a-novel-tracheobronchial-stent-loaded-with-125-i-seeds-in-patients-with-malignant-airway-obstruction-compared-to-a-conventional-stent-a-prospective-randomized-controlled-study
#7
RANDOMIZED CONTROLLED TRIAL
Yong Wang, Jian Lu, Jin-He Guo, Guang-Yu Zhu, Hai-Dong Zhu, Li Chen, Chao Wang, Gao-Jun Teng
BACKGROUND: 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. METHODS: 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...
July 2018: EBioMedicine
https://read.qxmd.com/read/29707506/airway-stents
#8
Erik Folch, Colleen Keyes
Stents and tubes to maintain the patency of the airways are commonly used for malignant obstruction and are occasionally employed in benign disease. Malignant airway obstruction usually results from direct involvement of bronchogenic carcinoma, or by extension of carcinomas occurring in the esophagus or the thyroid. External compression from lymph nodes or metastatic disease from other organs can also cause central airway obstruction. Most malignant airway lesions are surgically inoperable due to advanced disease stage and require multimodality palliation, including stent placement...
March 2018: Annals of Cardiothoracic Surgery
https://read.qxmd.com/read/29659423/safety-and-efficacy-of-oki-stenting-used-to-treat-obstructions-in-the-right-mainstem-bronchus
#9
Levent Dalar, Yasin Abul
BACKGROUND: Silicone stenting has been used to palliatively manage respiratory symptoms in patients with airway stenoses. Oki and Saka recently developed stents that can be used to manage stenoses around the carina between the bronchus to the right upper lobe and the bronchus intermedius (termed the primary right carina). The aim of this study was to assess the efficacy and safety of Oki stenting used to treat airway stenosis around the primary right carina. METHODS: We included 5 patients with airway stenoses...
July 2018: Journal of Bronchology & Interventional Pulmonology
https://read.qxmd.com/read/29538079/update-on-airway-stents
#10
Bruce F Sabath, David E Ost
PURPOSE OF REVIEW: The current review describes the latest evidence regarding the use of stents for malignant airway obstruction. RECENT FINDINGS: Therapeutic bronchoscopy, including stenting, can restore patency in up to 93% of patients with malignant central airway obstruction. The patients that benefit the most are those with worse baseline dyspnea, higher American Society of Anesthesiology score, poorer functional status, and central obstruction (rather than lobar)...
July 2018: Current Opinion in Pulmonary Medicine
https://read.qxmd.com/read/29534706/interventional-bronchoscopy-in-malignant-central-airway-obstruction-by-extra-pulmonary-malignancy
#11
Beomsu Shin, Boksoon Chang, Hojoong Kim, Byeong-Ho Jeong
BACKGROUND: Interventional bronchoscopy is considered an effective treatment option for malignant central airway obstruction (MCAO). However, there are few reports of interventional bronchoscopy in patients with MCAOs due to extra-pulmonary malignancy. Therefore, the objective of this study was to investigate treatment outcomes and prognostic factors for bronchoscopic intervention in patients with MCAO due to extra-pulmonary malignancy. METHODS: We retrospectively analyzed consecutive 98 patients with MCAO due to extra-pulmonary malignancy who underwent interventional bronchoscopy between 2004 and 2014 at Samsung Medical Center (Seoul, Korea)...
March 13, 2018: BMC Pulmonary Medicine
https://read.qxmd.com/read/29532563/external-beam-radiation-therapy-combined-with-airway-stenting-leads-to-better-survival-in-patients-with-malignant-airway-obstruction
#12
Christopher Mallow, Jeffrey Thiboutot, Roy Semaan, Margaret M Hayes, Russell Hales, Ashwin Ram, David Feller-Kopman, Hans Lee, Lonny Yarmus
BACKGROUND AND OBJECTIVE: Malignant airway obstruction (MAO), a common complication of patients with advanced lung cancer, causes debilitating dyspnoea and poor quality of life. Two common interventions used in the treatment of MAO include bronchoscopy with airway stenting and external beam radiotherapy (EBRT). Data are limited regarding their clinical effectiveness and overall effect on survival. METHODS: A retrospective chart review of patients treated with airway stenting and/or EBRT at the Johns Hopkins Hospital for MAO between July 2010 and January 2017 was reviewed...
March 12, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://read.qxmd.com/read/29482923/noninvasive-ventilation-as-a-temporizing-measure-in-critical-fixed-central-airway-obstruction-a-case-report
#13
Lenard Tai Win Cheng, Tiong Beng Sim, Win Sen Kuan
BACKGROUND: Critical central airway obstruction (CAO) requires emergent airway intervention, but current guidelines lack specific recommendations for airway management in the emergency department (ED) while awaiting rigid bronchoscopy. There are few reports of the use of noninvasive ventilation (NIV) in tracheomalacia, but its use as a temporizing treatment option in fixed, malignant CAO has not, to the best of our knowledge, been reported. CASE REPORT: An 84-year-old woman presented to the ED in respiratory distress, too breathless to speak and using her accessory muscles of respiration, with bilateral rhonchi throughout the lung fields...
May 2018: Journal of Emergency Medicine
https://read.qxmd.com/read/29214067/malignant-central-airway-obstruction
#14
REVIEW
Lakshmi Mudambi, Russell Miller, George A Eapen
This review comprehensively describes recent advances in the management of malignant central airway obstruction (CAO). Malignant CAO can be a dramatic and devastating manifestation of primary lung cancer or metastatic disease. A variety of diagnostic modalities are available to provide valuable information to plan a therapeutic intervention. Clinical heterogeneity in the presentation of malignant CAO provides opportunities to adapt and utilize endoscopic technology and tools in many ways. Mechanical debulking, thermal tools, cryotherapy and airway stents are methods and instruments used to rapidly restore airway patency...
September 2017: Journal of Thoracic Disease
https://read.qxmd.com/read/29049810/the-use-of-ultrasound-in-the-management-of-a-life-threatening-malignant-laryngotracheal-obstruction
#15
Alfonso Fiorelli, Gaetana Messina, Antonio Raucci, Mario Santini
Ultrasound is becoming a valuable diagnostic tool in the armamentarium of thoracic surgeons. We report its use to follow stent placement in the laryngotracheal position for management of life-threatening neoplastic obstruction. For this purpose, a 15-MHz linear probe was placed in the midline at the level of the cricoid cartilage. Ultrasound performed daily at bedside showed normal movement of vocal folds and no stent dislocation. This strategy may be an alternative to computed tomography scan or endoscopy to follow stent placement in extrathoracic airways...
February 1, 2018: Interactive Cardiovascular and Thoracic Surgery
https://read.qxmd.com/read/28932567/respiratory-support-with-venovenous-extracorporeal-membrane-oxygenation-during-stent-placement-for-the-palliation-of-critical-airway-obstruction-case-series-analysis
#16
Jung-Hoon Park, Ji Hoon Shin, Kun Yung Kim, Ju Yong Lim, Pyeong Hwa Kim, Jiaywei Tsauo, Min Tae Kim, Ho-Young Song
BACKGROUND: Venovenous extracorporeal membrane oxygenation (VV ECMO) is used to support gas transfer of patients suffering from respiratory failure during various procedures. The purpose of this study was to evaluate the technical feasibility and safety of fluoroscopic stent placement under respiratory support with VV ECMO in patients with critical airway obstructions. METHODS: We reviewed the records of 17 patients (14 male and 3 female; mean age: 63 years; range, 30-82 years) who underwent self-expandable metallic stent (SEMS) placement under VV ECMO respiratory support for critical airway obstruction caused by malignant (n=16) or benign (n=1) etiology...
August 2017: Journal of Thoracic Disease
https://read.qxmd.com/read/28915141/clinical-success-stenting-distal-bronchi-for-lobar-salvage-in-bronchial-stenosis
#17
Sonali Sethi, Thomas R Gildea, Francisco A Almeida, Joseph C Cicenia, Michael S Machuzak
BACKGROUND: Airway stents are traditionally used in central airway obstructions to maintain airway patency. Historically, distal bronchial stenting within lobar and segmental bronchi has not been amenable to stenting. In addition, there are questionable benefits to stenting small airways. The Atrium iCast stent is a polytetrafluoroethylene covered stainless steel balloon deployed stent which can be deployed through a flexible bronchoscope under direct visualization. The purpose of this study was to assess the feasibility, complications, and long-term impact of using this stent in patients with lobar bronchial stenosis either secondary to malignancy or benign etiologies...
January 2018: Journal of Bronchology & Interventional Pulmonology
https://read.qxmd.com/read/28474657/tracheal-stenting-under-flexible-bronchoscopy-for-large-tracheoesophageal-malignant-lymphadenopathy
#18
Irfan Ismail Ayub, Kalaichelvi Kannan, R Dhenesh, Anand Thiagarajan
A 67-year-old man with poorly controlled chronic obstructive pulmonary disease presented with progressive dysphagia and was diagnosed with locally advanced carcinoma of the esophagus. Positron emission tomography-computed tomography staging showed mediastinal lymphadenopathy including a large lymph node in the tracheoesophageal groove with moderate tracheal compression. He was advised chemoradiotherapy but was reluctant to proceed with the same. He developed stridor 2 months later and repeat imaging showed increased size of the tracheoesophageal lymph node with critical airway narrowing...
May 2017: Lung India: Official Organ of Indian Chest Society
https://read.qxmd.com/read/28449509/rapid-response-in-a-critical-lung-adenocarcinoma-presenting-as-large-airway-stenoses-after-receiving-stent-implantation-and-sequential-rebiopsy-guided-alk-inhibitor-therapy-a-case-report
#19
Ling Ding, Cheng Chen, Yuan-Yuan Zeng, Jian-Jie Zhu, Jian-An Huang, Ye-Han Zhu
Airway stent implantation can improve the symptoms of airway stenosis caused by a malignant tumor immediately. However, stent implantation is only a palliative therapy and disease will quickly progress without subsequent treatment. Targeted therapy can provide accurate etiological treatment for patients with critical lung cancer who cannot receive chemotherapies. In our clinic, we encountered a 50-year-old male presenting with stage IV lung adenocarcinoma. He failed both the first-line and second-line chemotherapies and suffered severe complex left and right main bronchial stenoses caused by tumor invasion...
March 2017: Journal of Thoracic Disease
https://read.qxmd.com/read/28389860/a-novel-self-expandable-radioactive-airway-stent-loaded-with-125-i-seeds-a-feasibility-and-safety-study-in-healthy-beagle-dog
#20
Yong Wang, Jin-He Guo, Guang-Yu Zhu, Hai-Dong Zhu, Li Chen, Jian Lu, Chao Wang, Gao-Jun Teng
PURPOSE: Airway stent placement is an effective treatment for the immediate palliation of malignant airway obstruction. However, restenosis caused by tumor ingrowth and/or overgrowth after stenting is common. The purpose of this study was to investigate the feasibility and safety of a novel self-expandable stent loaded with 125 I seeds in healthy beagle dog. MATERIALS AND METHODS: Under fluoroscopic guidance, forty-eight self-expandable airway stents loaded with 125 I seeds were perorally placed in the main trachea of 48 healthy beagle dogs, who were randomly divided into four groups (Group A: 0...
July 2017: Cardiovascular and Interventional Radiology
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