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Pulmonary Procedures |

Implantation of a Self-Expandable Metallic Y-Stent to Treat Tracheobronchial Stenosis: North American Clinical Experience

Sebastien Nguyen, MD; Simon Martel, MD; Mathieu Simon, MD; Noel Lampron, MD; Antoine Delage, MD
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Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Montreal, QC, Canada


Chest. 2015;148(4_MeetingAbstracts):849A. doi:10.1378/chest.2265622
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Abstract

SESSION TITLE: Rigid Bronchoscopy

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Self-expanding metallic Y stent (SEMS-Y) have been available in Europe since 2005 for treatment of central airway obstruction (CAO). To this day, there is no report documenting their use in North America.

METHODS: We performed a retrospective analysis of all patients treated for CAO with a self-expandable nitinol Y stent at our institution from October 2012 to January 2015.

RESULTS: Ten patients (age 37-83) had a SEMS-Y inserted by rigid bronchoscopy for treatment of malignant CAO secondary to NSCLC (n=9) and adenoid cystic carcinoma (n=1). In 8 patients, the SEMS-Y was deployed without any complication. Two patients developed tension pneumothorax during the procedure and were treated with tube thocacostomy. There were no deaths related to the stent deployment procedure. Mean length of stay post procedure was 5 days. In 5 patients in which stent deployment was the sole intervention, mean total procedural duration was 44 minutes. In patients for which follow up data was available (n=6), mean survival was 28 days. Relief of CAO was successful in all subjects who all noted immediate improvement of dyspnea. SEMS-Y complications included: mucus plugging requiring urgent bronchoscopy within 24 hours post deployment (n=2), persistent cough (n=1), granulation tissue formation (n=1) and pneumonia within 10 days post deployment (n=1).

CONCLUSIONS: Placement of self-expanding metallic Y stents is safe and effective in treating symptomatic malignant CAO. Severe complications related to the procedure are rare. SEMS-Y should be considered as an alternative option to silicone Y stent when treating malignant CAO.

CLINICAL IMPLICATIONS: Self-Expandable Metallic Y-stent are effective for symptomatic palliation of patients with central airway obstruction. Severe complications related to its deployment are rare. Self-Expandable Metallic Y-stent represent an interesting alternative to silicone Y stent.

DISCLOSURE: The following authors have nothing to disclose: Sebastien Nguyen, Simon Martel, Mathieu Simon, Noel Lampron, Antoine Delage

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