Abstract
Tracheomalacia (TM) is a tracheal weakening that causes the cartilage structure to collapse during breathing. The term tracheobronchomalacia (TBM) is used when the bronchi are also implicated in the disease. This illness can be treated in a variety of methods, including the insertion of stents in the cartilage-restricted region. Stents are commercially available in numerous sizes (diameter and length), different shapes and materials. The shape of the stent is chosen based on where the disease is located, while the size is derived from measurements on CT images or by endoscopic investigations. This task is extremely critical for the patient's health since improper stent can have serious and even deadly repercussions for the patient. Therefore, it is necessary to choose a stent that fits the patient's anatomy as closely as possible. To this end, it is possible to employ a three-dimensional model of the investigated anatomy and choose the most suitable type of stent following measurements made on the model itself. In this work, a method to assist physicians in the choice of the stent to be used in TM or TBM patients, is proposed. By analyzing the tracheobronchial tree and measuring successive cross-sections along the centerline of the lumen, the automated procedure allows to localize the diseased area and to identify the optimal shape and size of the stent to be implanted. Four case studies of paediatric patients were performed and the results were validated by a team of physicians specialized in the treatment of upper and lower airways.
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References
Choi, S., Lawlor, C., Rahbar, R., Jennings, R.: Diagnosis, classification, and management of pediatric tracheobronchomalacia: a review. JAMA Otolaryngol. - Head Neck Surg. 145, 265–275 (2019)
Sams, V.G., Lawson, C.M., Shibli, A.B., Taylor, D.A., Branca, P.R.: Severe tracheobronchomalacia after prolonged intubation of multitrauma patient. Case Rep Surg. 2011, 627012 (2011)
Eber, E., et al.: ERS statement: interventional bronchoscopy in children. Eur. Respir. J. 50, 1700901 (2017)
Rafanan, A.L., Mehta, A.C.: Stenting of the tracheobronchial tree. Radiol. Clin. North Am. 38, 395–408 (2000)
Ratnovsky, A., Regev, N., Wald, S., Kramer, M., Naftali, S.: Mechanical properties of different airway stents. Med. Eng. Phys. 37, 408–415 (2015)
Avasarala, S.K., Freitag, L., Mehta, A.C.: Metallic endobronchial stents: a contemporary resurrection. Chest 155, 1246–1259 (2019)
Dooms, C., De Keukeleire, T., Janssens, A., Carron, K.: Performance of fully covered self-expanding metallic stents in benign airway strictures. Respiration 77, 420–426 (2009)
Sommer, D., Forte, V.: Advances in the management of major airway collapse: the use of airway stents. Otolaryngol. Clin. North Am. 33, 163–177 (2000)
McLaren, C.A., Elliott, M.J., Roebuck, D.J.: Tracheobronchial intervention in children. Eur. J. Radiol. 53, 22–34 (2005)
Jacobs, J.P., et al.: The role of airway stents in the management of pediatric tracheal, carinal, and bronchial disease. Eur. J. Cardiothorac. Surg. 18, 505–512 (2000)
Arda, I.S., Boyvat, F., Ötgün, I., Güney, L.H., Hiçsönmez, A.: Preliminary experience with tracheal stent application in children with tracheal stenosis. Eur. J. Pediatr. Surg. 17, 241–243 (2007)
Lim, L.H.Y., Cotton, R.T., Azizkhan, R.G., Wood, R.E., Cohen, A.P., Rutter, M.J.: Complications of metallic stents in the pediatric airway. Otolaryngol. Head Neck Surg. 131, 355–361 (2004)
Saito, Y.: Endobronchial stents: Past, present, and future. Semin. Respir. Crit. Care Med. 25, 375–380 (2004)
Serio, P., Fainardi, V., Leone, R., Baggi, R., Grisotto, L., Biggeri, A., Mirabile, L.: Tracheobronchial obstruction: Follow-up study of 100 children treated with airway stenting. Europ. J. Cardiothorac. Surg. 45(4), e100–e109 (2014)
Wallis, C., McLaren, C.A.: Tracheobronchial stenting for airway malacia. Paediatr. Respir. Rev. 27, 48–59 (2018)
Dumon, J.F.: A dedicated tracheobronchial stent. Chest 97, 328–332 (1990)
Herth, F.J.F., Eberhardt, R.: Interventional bronchoscopy. Minerva Pneumologica. 43, 189–201 (2004)
Loskot, J., et al.: Raman spectroscopy as a novel method for the characterization of polydioxanone medical stents biodegradation. Materials 14(18), 5462 (2021)
Griffiths, B.T., James, P., Morgan, G., Diamantopoulos, A., Durward, A., Nyman, A.: Biodegradable stents for the relief of vascular bronchial compression in children with left atrial enlargement. J. Bronchology Interv. Pulmonol. 27, 200–204 (2020)
Serio, P., Mirabile, L.: Endoscopia respiratoria: diagnosi e terapia. In: Mirabile, L., Baroncini, S. (eds.) Rianimazione in età pediatrica, pp. 171–191. Springer Milan, Milano (2012). https://doi.org/10.1007/978-88-470-2059-7_16
Di Dedda, G., Mirabile, C.: Use of a biodegradable, oversized stent in a child with tracheomalacia secondary to vascular external compression. Cardiol. Young 27, 196–198 (2017)
Vondrys, D., Elliott, M.J., McLaren, C.A., Noctor, C., Roebuck, D.J.: First experience with biodegradable airway stents in children. Ann. Thorac. Surg. 92, 1870–1874 (2011)
Nicolai, T.: Airway stents in children. Pediatr. Pulmonol. 43, 330–344 (2008)
Natale, G., et al.: The use of 3D printing model as tool for planning endoscopic treatment of benign airway stenosis. Transl. Cancer Res. 9, 2117–2122 (2020)
Bücking, T.M., Hill, E.R., Robertson, J.L., Maneas, E., Plumb, A.A., Nikitichev, D.I.: From medical imaging data to 3D printed anatomical models. PLoS ONE 12, 1–10 (2017)
Rengier, F., et al.: 3D printing based on imaging data: review of medical applications. Int. J. Comput. Assist. Radiol. Surg. 5, 335–341 (2010)
Mussi, E., et al.: Current practice in preoperative virtual and physical simulation in neurosurgery. Bioengineering 7, 1–14 (2020)
Puggelli, L., Uccheddu, F., Volpe, Y., Furferi, R., Di Feo, D.: Accuracy assessment of CT-based 3D bone surface reconstruction. In: Cavas-MartÃnez, F., Eynard, B., Fernández Cañavate, F.J., Fernández-Pacheco, D.G., Morer, P., Nigrelli, V. (eds.) Advances on Mechanics, Design Engineering and Manufacturing II. LNME, pp. 487–496. Springer, Cham (2019). https://doi.org/10.1007/978-3-030-12346-8_47
Douglas, D.H., Peucker, T.K.: Algorithms for the reduction of the number of points required to represent a digitized line or its caricature. Cartographica: The Int. J. Geogr. Inform. Geovisualization 10(2), 112–122 (1973)
Santarelli, C., Puggelli, L., Carfagni, M., Governi, L.: Preliminary study of a high-fidelity simulator for the management of paediatric tracheal pathologies. In: Rizzi, C., Campana, F., Bici, M., Gherardini, F., Ingrassia, T., Cicconi, P. (eds.) ADM 2021. LNME, pp. 773–784. Springer, Cham (2022). https://doi.org/10.1007/978-3-030-91234-5_78
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Santarelli, C., Puggelli, L., Volpe, Y., Serio, P., Furferi, R. (2023). A Semiautomatic Procedure to Assist Physicians in Paediatric Airway Stenting. In: Gerbino, S., Lanzotti, A., Martorelli, M., Mirálbes Buil, R., Rizzi, C., Roucoules, L. (eds) Advances on Mechanics, Design Engineering and Manufacturing IV. JCM 2022. Lecture Notes in Mechanical Engineering. Springer, Cham. https://doi.org/10.1007/978-3-031-15928-2_15
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