SESSION TITLE: Bronchoscopy and Interventional Procedures
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Monday, October 27, 2014 at 01:30 PM - 02:30 PM
PURPOSE: Endobronchial stent insertion has become a common therapy for both malignant and non-malignant airway obstruction. This study aims to share our experience with endobronchial stents at a tertiary care facility.
METHODS: This study is a retrospective chart review of patients who underwent at least one endobronchial stent placement at The Johns Hopkins Hospital between 2010 and 2013. Using Current Procedural Terminology (CPT) codes 31631, 31636 and 31637, one hundred twenty one (121) patients were identified. Demographics information, initial stent type, indication for stent placement, and post-placement complications and interventions were collected for each patient.
RESULTS: The gender distribution was roughly equal (female 55.4%). Close to two thirds of patients (64.5%) had an endobronchial stent placed for a malignant indication. Among these, lung cancer accounted for 60.2% of cases (47.4% non-small cell and 12.8% small cell). The next most common malignancies were esophageal (10.3%), sarcoma (7.7%), breast (5.1%) and lymphoma (5.1%). Among non-malignant indications, tracheal stenosis was the most common (41.8%) followed by airway stenosis after lung transplant (23.3%) and tracheal or bronchial malacia (20.9%). A total of 133 stents were initially placed in 121 patients, including Aero® hybrid stents (Merrit Endotek, South Jordan, Utah) (42.9%), silicon stents (20.3%), silicone Y-stents (20.3%), Ultra flex® nitinol stents (Boston Scientific, Natick, MA) (9.0%) and T-tubes (7.5%). Eighty eight patients underwent a follow up bronchoscopy; forty one had a stent complication: 19 had stent migration, 12 had stent obstruction by granulation or tumor and 10 had stent obstruction by secretions. Therapeutic interventions performed during the first follow up bronchoscopy for all patients included stent removal (31.7%), stent replacement (23.3%), tumor or granulation tissue resection (20.0%), stent repositioning (10.0%), balloon dilation (8.3%) and additional stent insertion (6.7%).
CONCLUSIONS: Stent surveillance may be beneficial post-airway stent insertion.
CLINICAL IMPLICATIONS: Airway stent complications are common post-insertion and may need intervention to maintain patency of airway. The optimal timing or type of stent surveillance will need to be further examined.
DISCLOSURE: The following authors have nothing to disclose: Wassim Labaki, Ricardo Ortiz, Sophia Khalil, Amitosh Singh, David Feller-Kopman, Lonny Yarmus, Hans Lee
No Product/Research Disclosure Information