Treatment of malignant airway stenosis with 125I seed stent implantation assisted by airway tube: preliminary results in 24 patients / 介入放射学杂志

ABSTRACT

Objective To evaluate the safety and feasibility of 125I seeds stent implantation with assistance of airway tube under local anesthesia in treating malignant tracheobronchial stenosis.Methods The clinical data of 24 patients with malignant tracheal and bronchial stenosis,who underwent the treatment of 125I seed stent implantation at authors' institute during the period from March 2014 to January 2015,were retrospectively analyzed.The primary lesions included tracheal and bronchial cancer (n=6),esophageal carcinoma (n=8),pulmonary cancer associated with mediastinal lymph node metastasis (n=9),and malignant mediastinal tumor (n=l).All patients had different degrees of shortness of breath,cough and other symptoms due to airway constriction caused by malignant tumors.Grade Ⅱ of breath shortness was seen in 2 patients,grade Ⅲ in 16 patients,and grade Ⅳ in 6 patients.First,a 4F single-curve catheter was placed into one of the main bronchi,which was used as the ventilation catheter,then implantation of 125I seed stent in the diseased trachea and bronchus was carried out,finally,after the implantation of 125I seed stent was successfully accomplished the ventilation catheter was removed.The technical success rate of 125l seed stent implantation,the procedure-related complications and the intraoperative patient tolerance were calculated and the results were analyzed.Results Successful implantation of 125I seed stent with single procedure was accomplished in all 24 patients and no severe operation-related complications occurred.The technical success rate was 100％.Under the assistance of ventilation catheter,the oxygen saturation maintained at the level around 92.9％ when the stent release device was passing through the airway stenotic site.Neither intraoperative asphyxia nor severe decrease in blood oxygen saturation occurred in all patients.After the treatment,6 patients had bloody sputum,2 patients developed irritable cough,and one patient complained of mild chest pain,these symptoms were relieved after symptomatic treatment.During operation,no events that caused the patients unable to cooperate with the treatment,such as severe cough,dysphoria,dyspnea,etc.,occurred.Conclusion For the treatment of malignant airway stenosis,125I seed stent implantation with assistance of airway tube under local anesthesia is safe and feasible.