Pulmonary Procedures |

Dumon Silicone Y-Stenting in Malignant and Nonmalignant Central Airway Obstruction FREE TO VIEW

Sonali Sethi, MD; Thomas Gildea, MD; Francisco Almeida, MD; Michael Machuzak, MD
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Cleveland Clinic, Cleveland, OH

Chest. 2013;144(4_MeetingAbstracts):801A. doi:10.1378/chest.1703801
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SESSION TITLE: Bronchoscopy and Interventional Procedures Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Airway stents are deployed in central airways to reestablish luminal patency, relieve dyspnea, and prevent impending suffocation. Y-shaped stents provide treatment of malignant and non-malignant tracheobronchial stenosis, fistulas, vascular compression, surgical dehiscence, and tracheobronchialmalacia involving the lower trachea, main carina, and proximal mainstem bronchi. We report our experience at Cleveland Clinic in placing Dumon silicone Y-stents over 4 years.

METHODS: Bronchoscopy records of all patients who had placement of a Dumon Y-stent were retrospectively reviewed from the ACCP Quality Improvement Registry (AQuIRE) database between 3/2009-3/2013. For every patient, age, gender, location and histology of the malignant or benign process, duration of stent placement, outcome, and complications were recorded.

RESULTS: Over four years, a total of 125 Dumon Y-stents were deployed in 69 patients with central airway obstruction. Seventeen patients (average age 44.6 yrs) had non-malignant disease. A total of 65 Y-stents were deployed with an average of 3.8 stents/patient. Mean time to stent removal was 109.5 days. All patients had follow-up. Fifty-two patients (average age 60.6 yrs) had malignant disease. A total of 60 Y-stents were deployed with an average of 1.2 stents/patient. Mean time to stent removal was 126.2 days for patients with follow-up. Fifteen patients lost to follow-up were presumed deceased. No death was related to airway stenting complications. Sixty-six patients experienced symptomatic improvement. Three patients with non-malignant disease had stents removed for lack of symptom improvement or intolerability; one patient with malignant disease for mucous plugging. One stent was revised for intussusception into a T-tube. The patient experienced no adverse consequences. Granulation tissue formation was more common in patients with non-malignant diseases.

CONCLUSIONS: When preformed by experienced interventional pulmonologists, placing Y-stents is safe and effective in palliating or relieving central airway obstruction. Although more patients require Y-stent placement for malignant disease, the mean number of stents placed per patient is greater in non-malignant diseases. Complications due to stent placement are uncommon.

CLINICAL IMPLICATIONS: Although surgical correction is preferred when technically feasible and clinical status of the patient permits, Y-stenting provides a reliable alternative in selected cases and helps to improve quality of life in non-surgical patients.

DISCLOSURE: The following authors have nothing to disclose: Sonali Sethi, Thomas Gildea, Francisco Almeida, Michael Machuzak

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