Skip to main content
Log in

Follow-up after stent insertion in the tracheobronchial tree: role of helical computed tomography in comparison with fiberoptic bronchoscopy

  • Chest
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract.

The aim of this study was to compare helical CT with fiberoptic bronchoscopy findings to appraise the medium-term results of proximal-airways stenting. Twenty-five patients with 28 endobronchial metallic stents inserted for local advanced malignancy (n=13) or benign diseases (n=12) underwent follow-up CT from 3 days to 50 months (mean 8 months). All studies were obtained using helical CT with subsequent multiplanar reformation and three-dimensional reconstruction including virtual bronchoscopy. The location, shape, and patency of stents and adjacent airway were assessed. The results of CT were compared with the results of fiberoptic bronchoscopy obtained with a mean delay of 2.5 days (SD 9 days) after CT scan. Twelve stents (43%) remained in their original position, patent and without deformity. Sixteen stents were associated with local complications: migration (n=6); external compression with persistent stenosis (n=4); local recurrence of malignancy (n=4); fracture (n=1); and non-congruence between the airway and the stent (n=1). The CT demonstrated all the significant abnormalities demonstrated at fiberoptic bronchoscopy except two moderate stenoses (20%) related to granulomata at the origin of the stent . Ten of 14 stents inserted for benign conditions were without complications as compared with 2 of 14 in malignant conditions (p=0.008). Computed tomography is an accurate noninvasive method for evaluating endobronchial stents. The CT is a useful technique for follow-up of patients who have undergone endobronchial stenting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1a–d.
Fig. 2.
Fig. 3.
Fig. 4a–c.
Fig. 5a–d.
Fig. 6.

Similar content being viewed by others

References

  1. Rafanan AL, Mehta AC (2000) Stenting of the tracheobronchial tree. Radiol Clin North Am 38:395–408

    CAS  PubMed  Google Scholar 

  2. Seijo LM, Sterman DH (2001) Interventional pulmonology. N Engl J Med 344:740–749

    Article  CAS  PubMed  Google Scholar 

  3. Sonett JR, Keenan RJ, Ferson PF, Griffith BP, Landreneau RJ (1995) Endobronchial management of benign, malignant, and lung transplantation airway stenoses. Ann Thorac Surg 59:1417–1422

    Article  PubMed  Google Scholar 

  4. Mehta AC, Dasgupta A (1999) Airway stents. Clin Chest Med 20:139–151

    CAS  PubMed  Google Scholar 

  5. Rousseau H, Dahan M, Lauque D et al. (1993) Self-expandable prostheses in the tracheobronchial tree. Radiology 188:199–203

    CAS  PubMed  Google Scholar 

  6. Lehman JD, Gordon RL, Kerlan RK Jr et al. (1998) Expandable metallic stents in benign tracheobronchial obstruction. J Thorac Imaging 13:105–115

    CAS  PubMed  Google Scholar 

  7. Faul JL, Kee ST, Rizk NW (1999) Endobronchial stenting for severe airway obstruction in relapsing polychondritis. Chest 116:825–827

    CAS  PubMed  Google Scholar 

  8. Weiss JP, Sexauer WP, Saab EM (1995) Bronchial obstruction secondary to aortic pseudoaneurysm: treatment with an expandable metallic stent. AJR 165:547–549

    CAS  Google Scholar 

  9. Wadsworth SJ, Juniper MC, Benson MK, Gleeson FV (1999) Fatal complication of an expandable metallic bronchial stent. Br J Radiol 72:706–708

    CAS  PubMed  Google Scholar 

  10. Ferretti GR, Bricault I, Coulomb M (2001) Virtual tools for imaging of the thorax. Eur Respir J 18:381–392

    CAS  PubMed  Google Scholar 

  11. Dumon JF (1990) A dedicated tracheobronchial stent. Chest 97:328–332

    CAS  PubMed  Google Scholar 

  12. Brichet A, Verkindre C, Dupont J et al. (1999) Multidisciplinary approach to management of postintubation tracheal stenoses. Eur Respir J 13:888–893

    CAS  PubMed  Google Scholar 

  13. Bolliger CT, Heitz M, Hauser R, Probst R, Perruchoud AP (1996) An airway wallstent for the treatment of tracheobronchial malignancies. Thorax 51:1127–1129

    CAS  PubMed  Google Scholar 

  14. Monnier P, Mudry A, Stanzel F et al. (1996) The use of the covered Wallstent for the palliative treatment of inoperable tracheobronchial cancers. A prospective, multicenter study. Chest 110:1161–1168

    CAS  PubMed  Google Scholar 

  15. Aggarwal A, Dasgupta A, Mehta AC (1999) Metalloptysis expulsion of wire stent fragments. Chest 115:1484–1485

    CAS  Google Scholar 

  16. Ferretti GR, Knoplioch J, Bricault I, Brambilla C, Coulomb M (1997) Central airway stenoses: preliminary results of spiral-CT-generated virtual bronchoscopy simulations in 29 patients. Eur Radiol 7:854–859

    Article  CAS  PubMed  Google Scholar 

  17. Ferretti GR, Thony F, Bosson JL, Pison C, Arbib F, Coulomb M (2000) Benign abnormalities and carcinoid tumors of the central airways: diagnostic impact of CT bronchography. AJR 174:1307–1313

    CAS  Google Scholar 

  18. Remy J, Remy-Jardin M, Artaud D, Fribourg M (1998) Multiplanar and three-dimensional reconstruction techniques in CT: impact on chest diseases. Eur Radiol 8:335–351

    PubMed  Google Scholar 

  19. Jones LM, Mair EA, Fitzpatrick TM, Lyon RD, Feuerstein IM (2000) Multidisciplinary airway stent team: a comprehensive approach and protocol for tracheobronchial stent treatment. Ann Otol Rhinol Laryngol 109:889–898

    CAS  PubMed  Google Scholar 

  20. Matsuo T, Colt HG (2000) Evidence against routine scheduling of surveillance bronchoscopy after stent insertion. Chest 118:1455–1459

    CAS  PubMed  Google Scholar 

  21. Hauck RW, Lembeck RM, Emslander HP, Schomig A (1997) Implantation of Accuflex and Strecker stents in malignant bronchial stenoses by flexible bronchoscopy. Chest 112:134–144

    CAS  PubMed  Google Scholar 

  22. Boiselle PM, Reynolds KF, Ernst A (2002) Multiplanar and three-dimensional imaging of the central airways with multidetector CT. AJR 179:301–308

    Google Scholar 

  23. Grenier PA, Beigelman-Aubry C, Fetita C, Preteux F, Brauner MW, Lenoir S (2002) New frontiers in CT imaging of airway disease. Eur Radiol 12:1022–1244

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to G. R. Ferretti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ferretti, G.R., Kocier, M., Calaque, O. et al. Follow-up after stent insertion in the tracheobronchial tree: role of helical computed tomography in comparison with fiberoptic bronchoscopy. Eur Radiol 13, 1172–1178 (2003). https://doi.org/10.1007/s00330-003-1820-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-003-1820-0

Keywords

Navigation