Ventilatory catheter-assisted airway stenting under local anesthesia for patients with malignant airway stenosis / 中华放射学杂志

ABSTRACT

Objective To discuss the ventilatory catheter-assisted airway stenting under local anesthesia for airway stenosis.Methods From May 2008 to January 2013,25 consecutive patients with airway stenosis underwent the treatment of ventilatory catheter-assisted airway stenting under local anesthesia.The dyspnea score was grade Ⅱ in 3 patients,grade Ⅲ in 18 patients and grade Ⅳ in 4 patients.During the treatment,a 4 F VER catheter was placed into one of the main bronchi as a ventilatory catheter for oxygen supply in advance,the oxygen flow was set at 2 to 4 L/rmin according to the patients' condition,then the airway stenting was performed,after release of the stent,the ventilatory catheter was removed smoothly.Data on technical success,clinical outcome and follow-up were collected and analyzed respectively.The paired t test was performed to compare variables before and after tracheal stenting.Results Ventilatory catheter-assisted airway stenting under local anesthesia was technically successful in all patients.A total of 25 stents were placed in 25 patients.The stents included I-shaped stents (n=19) and Y-shaped stents (n=6).After the oxygen supply,the patients' SaO2 was increased to 94％ to 97％ rapidly.When the stent introducer sheaths were passing through the stenotic site,the SaO2 could be maintained at 92％ to 97％.The improvement of the respiratory difficulty was achieved in 100％ of our patients.The hypoxia symptom was relieved immediately after stents placement,the dyspnea score decreased to grade 0 in 2 patients,to grade Ⅰ in 19 patients and to grade Ⅱ in 4 patients.Respiratory rate and SaO2 improved from (30.0±2.1) times/min and (6.0±3.8)％ before stenting to (19.7±1.6) times/min (t=23.33,P＜0.01) and (93.0± 1.7)％ (t=23.50,P＜0.01) after stenting,respectively.Through the follow-up,3 patients suffered the stent-related complications after discharge,the complications included re-stenosis (n=2) and fracture(n=1).Conclusion Ventilatory catheter-assisted airway stenting under local anesthesia can be an effective,simple and safe method for airway stenosis.