Benign tracheobronchial stenoses: Changes in short-term and long-term pulmonary function testing after expandable metallic stent placement

Michael Gotway, Jeffrey A. Golden, Jeanne M. LaBerge, W. Richard Webb, Gautham P. Reddy, Mark W. Wilson, Robert K. Kerlan, Roy L. Gordon

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Purpose: To determine the short- and long-term improvement in airflow dynamics in patients undergoing tracheobronchial stent placement for benign airway stenoses. Methods: Twenty-two patients underwent 34 tracheal and/or bronchial stent placement procedures for benign airway stenoses and had the results of pulmonary function tests available. Stent placement indications included bronchomalacia after lung transplantation (n = 11), postintubation stenoses (n = 6), relapsing polychondritis (n = 2), and 1 each of tracheomalacia, tracheal compression, and histoplasmosis. Six patients underwent more than one stent placement procedure (range: 2-7 procedures). The mean forced expiratory volume in one second (FEV1), forced expiratory flow rate in the midportion of the forced vital capacity curve (FEF25-75), forced vital capacity, and peak flow (PF) rate obtained before stent placement were compared with those immediately after stent placement and with those measurements most remote from stent placement using the paired two-tailed t test. Results: All patients reported improved respiratory function immediately after stent placement. The mean FEV1, FEF25-75, and PF rate improved significantly (p < 0.001, p = 0.002, and p = 0.009, respectively) after stent placement. On long-term follow-up averaging 15 months after stent placement, these parameters declined despite patients' subjective sense of improvement. Segregating the population into transplant and nontransplant airway stenosis etiologies, however, FEF25-75 and PF rate remained significantly improved (p = 0.045, p = 0.027, respectively), over the long term for the latter. FEV1 increased after subsequent stent placements for patients receiving multiple stents. Conclusion: Stent placement for benign tracheobronchial stenoses provides significant immediate improvement in airflow dynamics. Long-term improvement in airflow obstruction may be expected, and additional stent placements may further improve pulmonary function.

Original languageEnglish (US)
Pages (from-to)564-572
Number of pages9
JournalJournal of Computer Assisted Tomography
Volume26
Issue number4
DOIs
StatePublished - Jul 2002
Externally publishedYes

Fingerprint

Stents
Pathologic Constriction
Lung
Vital Capacity
Bronchomalacia
Forced Expiratory Flow Rates
Tracheomalacia
Relapsing Polychondritis
Histoplasmosis
Lung Transplantation
Respiratory Function Tests
Forced Expiratory Volume
Transplants

Keywords

  • Airway
  • Outcome
  • Pulmonary function testing
  • Stenosis
  • Stent

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Benign tracheobronchial stenoses : Changes in short-term and long-term pulmonary function testing after expandable metallic stent placement. / Gotway, Michael; Golden, Jeffrey A.; LaBerge, Jeanne M.; Webb, W. Richard; Reddy, Gautham P.; Wilson, Mark W.; Kerlan, Robert K.; Gordon, Roy L.

In: Journal of Computer Assisted Tomography, Vol. 26, No. 4, 07.2002, p. 564-572.

Research output: Contribution to journalArticle

Gotway, Michael ; Golden, Jeffrey A. ; LaBerge, Jeanne M. ; Webb, W. Richard ; Reddy, Gautham P. ; Wilson, Mark W. ; Kerlan, Robert K. ; Gordon, Roy L. / Benign tracheobronchial stenoses : Changes in short-term and long-term pulmonary function testing after expandable metallic stent placement. In: Journal of Computer Assisted Tomography. 2002 ; Vol. 26, No. 4. pp. 564-572.
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AU - Gotway, Michael

AU - Golden, Jeffrey A.

AU - LaBerge, Jeanne M.

AU - Webb, W. Richard

AU - Reddy, Gautham P.

AU - Wilson, Mark W.

AU - Kerlan, Robert K.

AU - Gordon, Roy L.

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AB - Purpose: To determine the short- and long-term improvement in airflow dynamics in patients undergoing tracheobronchial stent placement for benign airway stenoses. Methods: Twenty-two patients underwent 34 tracheal and/or bronchial stent placement procedures for benign airway stenoses and had the results of pulmonary function tests available. Stent placement indications included bronchomalacia after lung transplantation (n = 11), postintubation stenoses (n = 6), relapsing polychondritis (n = 2), and 1 each of tracheomalacia, tracheal compression, and histoplasmosis. Six patients underwent more than one stent placement procedure (range: 2-7 procedures). The mean forced expiratory volume in one second (FEV1), forced expiratory flow rate in the midportion of the forced vital capacity curve (FEF25-75), forced vital capacity, and peak flow (PF) rate obtained before stent placement were compared with those immediately after stent placement and with those measurements most remote from stent placement using the paired two-tailed t test. Results: All patients reported improved respiratory function immediately after stent placement. The mean FEV1, FEF25-75, and PF rate improved significantly (p < 0.001, p = 0.002, and p = 0.009, respectively) after stent placement. On long-term follow-up averaging 15 months after stent placement, these parameters declined despite patients' subjective sense of improvement. Segregating the population into transplant and nontransplant airway stenosis etiologies, however, FEF25-75 and PF rate remained significantly improved (p = 0.045, p = 0.027, respectively), over the long term for the latter. FEV1 increased after subsequent stent placements for patients receiving multiple stents. Conclusion: Stent placement for benign tracheobronchial stenoses provides significant immediate improvement in airflow dynamics. Long-term improvement in airflow obstruction may be expected, and additional stent placements may further improve pulmonary function.

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KW - Outcome

KW - Pulmonary function testing

KW - Stenosis

KW - Stent

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