Abstract
Purpose
To assess the efficacy of the Wallstent endoprosthesis in malignant tracheobronchial obstruction.
Methods
Seven patients with irresectable carcinoma of the bronchus were treated with nine Wallstent endoprostheses. The procedures were performed under endoscopic and fluoroscopic guidance. Wallstent endoprostheses ranging from 8–16 mm in diameter and 26–49 mm in length were deployed after balloon dilatation of the strictures.
Results
All stents were successfully deployed in the desired positions. There was one procedural complication and one procedure-related death. Three patients showed significant improvement in respiratory status after stenting. At a mean follow-up of 5.1 months, there has been no stent migration, fracture, or collapse. One patient had proximal tumor overgrowth that was treated with additional stent insertion. One patient died after a bout of massive hemoptysis 3 months poststenting and it was difficult to tell whether this was related to the endoprosthesis.
Conclusion
The use of the Wallstent endoprosthesis in malignant tracheobronchial obstruction is technically feasible.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Adam A, Chetty N, Roddie M, Yeung E, Benjamin IS (1991) Self-expandable stainless steel endoprostheses for treatment of malignant bile duct obstruction. AJR 156:321–325
Rossi P, Bezzi M, Rossi M, Adam A, Chetty N, Roddie ME, Iacari V, Cwikiel W, Zollikofer CL, Antonucci F (1994) Metallic stents in malignant biliary obstruction: Results of a multicenter European study of 240 patients. J Vasc Intervent Radiol 5:279–285
Dyet JF, Nicholson AA, Cook AM (1993) The use of the Wallstent endovascular prosthesis in the treatment of malignant obstruction of the superior vena cava. Clin Radiol 48:381–385
Watkinson AF, Hansell DM (1993) Expandable Wallstent for the treatment of obstruction of the superior vena cava. Thorax 48:915–920
Entwisle KG, Watkinson AF, Hibbert J, Adam A (1995) The use of the Wallstent endovascular prosthesis in the treatment of malignant inferior vena cava obstruction. Clin Radiol 50:310–313
Watkinson AF, Ellul J, Entwisle K, Mason RC, Adam A (1995) Esophageal carcinoma: Initial results of palliative treatment with covered self-expanding endoprostheses. Radiology 195:821–827
Watkinson A, Ellul J, Entwisle K, Farrugia M, Mason R, Adam A (1995) Plastic-covered metallic endoprostheses in the management of oesophageal perforation in patients with oesophageal carcinoma. Clin Radiol 50:304–309
Wallace MJ, Charnsangavej C, Ogawa K, Carrasco HC, Wright KC, McKenna R, McMurtrey M, Gianturco C (1986) Tracheobronchial tree: Expandable metallic stents used in experimental and clinical applications. Radiology 158:309–312
Varela A, Maynar M, Irving D, Dick R, Reyes R, Rousseau H, Lopez L, Pulido-Duque JM, Letourneau JG, Castaneda-Zuniga WR (1990) Use of the Gianturco self-expandable stents in the tracheobronchial tree. Ann Thorac Surg 49:806–809
George PJM, Irving JD, Khaghani A, Dick R (1992) Role of the Gianturco expandable metal stent in the management of tracheobronchial obstruction. Cardiovasc Intervent Radiol 15:375–381
Sawada S, Tanigawa N, Kobayashi M, Furui S, Ohta Y (1993) Malignant tracheobronchial obstructive lesions: Treatment with Gianturco expandable metallic stents Radiology 188:205–208
Egan AM, Dennis C, Flower CDR (1993) Expandable metal stents for tracheobronchial obstruction. Clin Radiol 49:162–165
Irving JD, Goldstraw JD (1991) Tracheobronchial stents. Semin Intervent Radiol 8:295–304
Rousseau H, Dahan M, Lauque D, Carre P, Didier A, Bilbao I, Herrero J, Blancjouvant F, Joffre F (1993) Self-expandable prostheses in the tracheobronchial tree. Radiology 188:199–203
Carre P, Rosseau H, Lombart L, Didier A, Dahan M, Fournial G, Leophonte P, Toulouse Lung Transplantation Group (1994) Balloon dilatation and self-expanding metal Wallstent insertion for management of bronchostenosis following lung transplantation. Chest 105:343–348
Tsang V, Williams AM, Goldstraw P (1992) Sequential silastic and expandable metal stenting for tracheobronchial strictures. Ann Thorac Surg 53:856–860
Task Group on Screening for Respiratory Disease in Occupational Settings (1982) Official statement of the American Thoracic Society. Am Rev Respir Dis 126:952–956
Montgomery WW (1965) T-tube tracheal stent. Arch Otolaryngol 82:320–321
Westaby S, Jackson JW, Pearson FG (1982) A bifurcated silicone rubber stent for relief of tracheobronchial obstruction. J Thorac Cardiovasc Surg 83:414–417
Insall RL, Morritt GN (1991) Palliation of malignant tracheal strictures with silicone T-tubes. Thorax 46:168–171
Belsey R (1951) Resection and reconstruction of the intrathoracic trachea. Br J Surg 38:200–205
George PJM, Irving JD, Mantell BS, Rudd RM (1990) Covered expandable metal stent for recurrent tracheal obstruction. Lancet 335:582–584
Kishi K, Kobayashi H, Suruda T, Ohata M, Sonomura T, Nishida N, Sato M, Yamada R (1994) Treatment of malignant tracheobronchial stenosis by Dacron mesh-covered Z-stents. Cardiovasc Intervent Radiol 17:33–35
Alfaro J, Varela G, De-Miguel E, Martin de Nicholas JL (1993) Successful treatment of a tracheo-innominate artery fistula following placement of a wire self-expandable tracheal Gianturco stent. Eur J Cardio-Thorac Surg 7:615–616
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tan, BS., Watkinson, A.F., Dussek, J.E. et al. Metallic endoprostheses for malignant tracheobronchial obstruction: Initial experience. Cardiovasc Intervent Radiol 19, 91–96 (1996). https://doi.org/10.1007/BF02563900
Issue Date:
DOI: https://doi.org/10.1007/BF02563900