Factors leading to obstructive granulation tissue formation after ultraflex stenting in benign tracheal narrowing.

Abstract

BACKGROUND:

This retrospective study aimed to determine the factors leading to obstructive granulation tissue formation after the placement of a self-expandable metallic stent (SEMS) in patients with benign tracheal disease.

METHODS:

From 2001 to 2007, a total of 67 patients (age: 62.1 +/- 15.4 years; range: 23-87 years) with benign tracheal disease received 75 ultraflex SEMS in our institution.

RESULTS:

There were 35 SEMSs complicated by obstructive granulation tissue formation out of the 75 stents placed in patients with tracheal disease, giving an incidence of 47.8 % (32/67 patients). The median time until developing granulation tissue was 106 days (IQR, 46-396). Structural airway obstruction prior to SEMS implantation independently predicted obstructive granulation tissue formation after SEMS implantation (odds ratio: 3.84; 95 % CI: 1.01-8.7; P = 0.04). Time to granulation tissue detection was shorter in patients with structural airway obstruction before SEMS implantation (structural airway obstruction vs. dynamic collapse airway: median [IQR] 95 [38-224, n = 26] vs. 396 days [73-994, n = 9]; P = 0.02).

CONCLUSIONS:

Obstructive granulation tissue formation is not uncommon after SEMS implantation and structural airway obstruction prior to SEMS implantation is an independent predictor. Although SEMS implantation should be restricted to a select population, it may be placed in patients not suitable for surgical intervention or rigid bronchoscopy with anesthesia because of poor pulmonary function.

• Authors: F-T Chung, S-M Lin, C-L Chou, H-C Chen, C-Y Liu, C-T Yu, H-P Kuo
• Journal: The Thoracic and cardiovascular surgeon (Thorac Cardiovasc Surg) Vol. 58 Issue 2 Pg. 102-7 (Mar 2010) ISSN: 1439-1902 [Electronic] Germany
• PMID: 20333573 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Airway Obstruction (diagnosis, etiology, pathology, therapy)
• Bronchoscopy
• Foreign-Body Reaction (diagnosis, etiology, pathology, therapy)
• Granulation Tissue (pathology)
• Humans
• Kaplan-Meier Estimate
• Logistic Models
• Middle Aged
• Odds Ratio
• Patient Selection
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Stents (adverse effects)
• Time Factors
• Tomography, X-Ray Computed
• Tracheal Stenosis (diagnosis, therapy)
• Young Adult