PURPOSE: The purpose of this study was to evaluate role of computed tomography (CT) scan features of air-pockets (tracheobronchial air columns in the space between the outer surface of the stent and the adjacent airway wall) in predicting outcome of stent removal after silicone stent placement in patients with post-tuberculosis tracheobronchial stenosis (PTTS).
METHODS: We retrospectively investigated 41 patients who underwent silicone stent placement due to PTTS, followed by removal 6-12 months after clinical stabilization. Two pulmonologists evaluated the extent of peri-prosthesis air pockets on the CT scans done within 6 months prior to removal. Success was defined as maintenance of prosthesis free airway for more than 2 years after removal.
RESULTS: Stents were successfully removed in 31 (76%) of patients. Positive correlation was found between the air-pocket length and indwelling time prior to removal in the success group (r = 0.37, P = 0.03). Presence of > 1 or >2 cm in length of air-pockets around the stent showed high tendency of successful stent removal (P = 0.002 and 0.006 respectively). Sensitivity and specificity of successful removal were 90% and 60% respectively, in > 1cm group and 74% and 80% respectively, in > 2cm group. Patients in failure group had longer than 2 years of indwelling time prior to removal of stent (P = 0.01).
CONCLUSIONS: Extent of the air-pockets on the chest CT scan correlates with the success of stent removal and may guide optimal time for stent removal.
CLINICAL IMPLICATIONS: Evaluation of these may help Interventional pulmonologists by serving as a guide to optimal time for removing stent and avoiding premature removal.
DISCLOSURE: The following authors have nothing to disclose: Akash Verma, Hojoong Kim, Hye Yun Park, So Yeon Lim, Sang-Won Um, Won-Jung Koh, Gee Young Suh, Man Pyo Chung, O Jung Kwon
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