Skip to main content
Top
Published in: CardioVascular and Interventional Radiology 5/2013

01-10-2013 | Clinical Investigation

Fluoroscopically Guided Balloon Dilation for Postintubation Tracheal Stenosis

Authors: Woong Hee Lee, Jin Hyoung Kim, Jung-Hun Park

Published in: CardioVascular and Interventional Radiology | Issue 5/2013

Login to get access

Abstract

Purpose

Little was known about the safety and long-term efficacy of fluoroscopically guided balloon dilation for postintubation tracheal stenosis. The purpose of this study was to evaluate the safety and long-term efficacy of fluoroscopically guided balloon dilation in patients with postintubation tracheal stenosis.

Methods

From February 2000 to November 2010, 14 patients underwent fluoroscopically guided balloon dilation for postintubation tracheal stenosis. Technical success, clinical success, and complications were evaluated. Patients were followed up for recurrent symptoms.

Results

In all patients, fluoroscopically guided balloon dilation was technically and clinically successful with no major complications. Following the initial procedure, six patients (43 %) remained asymptomatic during a follow-up period. Obstructive symptoms recurred in eight patients (57 %) within 6 months (mean, 1.7 months), who were treated with repeat balloon dilation (n = 4) and other therapies. Of the four patients who underwent repeat balloon dilation, three became asymptomatic. One patient became asymptomatic after a third balloon dilation. On long-term (mean, 74 months) follow-up, 71 % of patients experienced relief of symptoms following fluoroscopically guided balloon dilation.

Conclusions

Fluoroscopically guided balloon dilation may be safe, is easy to perform, and resulted in effective treatment in patients with postintubation tracheal stenosis.
Literature
1.
go back to reference Lorenz RR (2003) Adult laryngotracheal stenosis: etiology and surgical management. Curr Opin Otolaryngol Head Neck Surg 11:467–472PubMedCrossRef Lorenz RR (2003) Adult laryngotracheal stenosis: etiology and surgical management. Curr Opin Otolaryngol Head Neck Surg 11:467–472PubMedCrossRef
2.
go back to reference Arola MK, Inberg MV, Puhakka H (1981) Tracheal stenosis after tracheostomy and after orotracheal cuffed intubation. Acta Chir Scand 147:183–192PubMed Arola MK, Inberg MV, Puhakka H (1981) Tracheal stenosis after tracheostomy and after orotracheal cuffed intubation. Acta Chir Scand 147:183–192PubMed
3.
go back to reference Healy GB (1989) Subglottic stenosis. Otolaryngol Clin North Am 22:599–606PubMed Healy GB (1989) Subglottic stenosis. Otolaryngol Clin North Am 22:599–606PubMed
4.
go back to reference Lund T, Goodwin CW, McManus WF et al (1985) Upper airway sequelae in burn patients requiring endotracheal intubation or tracheostomy. Ann Surg 201:374–382PubMedCrossRef Lund T, Goodwin CW, McManus WF et al (1985) Upper airway sequelae in burn patients requiring endotracheal intubation or tracheostomy. Ann Surg 201:374–382PubMedCrossRef
5.
6.
go back to reference Melkane AE, Matar NE, Haddad AC et al (2010) Management of postintubation tracheal stenosis: appropriate indications make outcome differences. Respiration 79:395–401PubMedCrossRef Melkane AE, Matar NE, Haddad AC et al (2010) Management of postintubation tracheal stenosis: appropriate indications make outcome differences. Respiration 79:395–401PubMedCrossRef
7.
go back to reference Caliguiri PA, Banner AS, Jensik RJ (1984) Tuberculous main-stem bronchial stenosis treated with sleeve resection. Arch Intern Med 144:1302–1303CrossRef Caliguiri PA, Banner AS, Jensik RJ (1984) Tuberculous main-stem bronchial stenosis treated with sleeve resection. Arch Intern Med 144:1302–1303CrossRef
8.
go back to reference Dumon JF, Rebound E, Garbe L, Aucomte F, Meric B (1982) Treatment of tracheobronchial lesions by laser photoresection. Chest 81:278–284PubMedCrossRef Dumon JF, Rebound E, Garbe L, Aucomte F, Meric B (1982) Treatment of tracheobronchial lesions by laser photoresection. Chest 81:278–284PubMedCrossRef
9.
go back to reference Cohen MD, Weber TR, Rao CC (1984) Balloon dilatation of tracheal and bronchial stenosis. AJR Am J Roentgenol 142:477–478PubMedCrossRef Cohen MD, Weber TR, Rao CC (1984) Balloon dilatation of tracheal and bronchial stenosis. AJR Am J Roentgenol 142:477–478PubMedCrossRef
10.
go back to reference Carlin BW, Harell JH, Moser KM (1988) The treatment of endobronchial stenosis using balloon catheter dilatation. Chest 93:1148–1151PubMedCrossRef Carlin BW, Harell JH, Moser KM (1988) The treatment of endobronchial stenosis using balloon catheter dilatation. Chest 93:1148–1151PubMedCrossRef
11.
go back to reference Rousseau H, Dahan M, Lauque D et al (1993) Self-expandable prostheses in the tracheobronchial tree. Radiology 188:199–203PubMed Rousseau H, Dahan M, Lauque D et al (1993) Self-expandable prostheses in the tracheobronchial tree. Radiology 188:199–203PubMed
12.
go back to reference Song HY, Shim TS, Kang SG et al (1999) Tracheobronchial strictures: treatment with a polyurethane-covered retrievable expandable nitinol stent: initial experience. Radiology 213:905–912PubMed Song HY, Shim TS, Kang SG et al (1999) Tracheobronchial strictures: treatment with a polyurethane-covered retrievable expandable nitinol stent: initial experience. Radiology 213:905–912PubMed
13.
go back to reference Vergnon JM, Costes F, Polio JC (2000) Efficacy and tolerance of a new silicone stent for the treatment of benign tracheal stenosis: preliminary results. Chest 118:422–426PubMedCrossRef Vergnon JM, Costes F, Polio JC (2000) Efficacy and tolerance of a new silicone stent for the treatment of benign tracheal stenosis: preliminary results. Chest 118:422–426PubMedCrossRef
14.
go back to reference Bisson A, Bonnette P, el Kadi NB et al (1992) Tracheal sleeve resection for iatrogenic stenoses (subglottic laryngeal and tracheal). J Thorac Cardiovasc Surg 104:882–887PubMed Bisson A, Bonnette P, el Kadi NB et al (1992) Tracheal sleeve resection for iatrogenic stenoses (subglottic laryngeal and tracheal). J Thorac Cardiovasc Surg 104:882–887PubMed
15.
go back to reference Grillo HC, Mathisen DJ, Wain JC (1992) Laryngotracheal resection and reconstruction for subglottic stenosis. Ann Thorac Surg 53:54–63PubMedCrossRef Grillo HC, Mathisen DJ, Wain JC (1992) Laryngotracheal resection and reconstruction for subglottic stenosis. Ann Thorac Surg 53:54–63PubMedCrossRef
16.
go back to reference Ferretti G, Jouvan FB, Thony F, Pison C, Coulomb M (1995) Benign noninflammatory bronchial stenosis: treatment with balloon dilation. Radiology 196:831–834PubMed Ferretti G, Jouvan FB, Thony F, Pison C, Coulomb M (1995) Benign noninflammatory bronchial stenosis: treatment with balloon dilation. Radiology 196:831–834PubMed
17.
go back to reference Sheski FD, Mathur PN (1998) Long-term results of fiberoptic bronchoscopic balloon dilation in the management of benign tracheobronchial stenosis. Chest 114:796–800PubMedCrossRef Sheski FD, Mathur PN (1998) Long-term results of fiberoptic bronchoscopic balloon dilation in the management of benign tracheobronchial stenosis. Chest 114:796–800PubMedCrossRef
18.
go back to reference Kim JH, Shin JH, Song HY et al (2008) Liquid (188) Re-filled balloon dilation for the treatment of refractory benign airway strictures: preliminary experience. J Vasc Interv Radiol 19:406–411PubMedCrossRef Kim JH, Shin JH, Song HY et al (2008) Liquid (188) Re-filled balloon dilation for the treatment of refractory benign airway strictures: preliminary experience. J Vasc Interv Radiol 19:406–411PubMedCrossRef
19.
go back to reference Iwamoto Y, Miyazawa T, Kurimoto N et al (2004) Interventional bronchoscopy in the management of airway stenosis due to tracheobronchial tuberculosis. Chest 126:1344–1352PubMedCrossRef Iwamoto Y, Miyazawa T, Kurimoto N et al (2004) Interventional bronchoscopy in the management of airway stenosis due to tracheobronchial tuberculosis. Chest 126:1344–1352PubMedCrossRef
20.
go back to reference Kapoor BS, May B, Panu N, Kowalik K, Hunter DW (2007) Endobronchial stent placement for the management of airway complications after lung transplantation. J Vasc Interv Radiol 18:629–632PubMedCrossRef Kapoor BS, May B, Panu N, Kowalik K, Hunter DW (2007) Endobronchial stent placement for the management of airway complications after lung transplantation. J Vasc Interv Radiol 18:629–632PubMedCrossRef
21.
go back to reference Kim JH, Shin JH, Song HY et al (2007) Tracheobronchial laceration after balloon dilation for benign strictures: incidence and clinical significance. Chest 131:1114–1117PubMedCrossRef Kim JH, Shin JH, Song HY et al (2007) Tracheobronchial laceration after balloon dilation for benign strictures: incidence and clinical significance. Chest 131:1114–1117PubMedCrossRef
22.
go back to reference Carre P, Rousseau H, Lombart L et al (1994) Balloon dilatation and self-expanding metal Wallstent insertion for management of bronchostenosis following lung transplantation. The Toulouse Lung Transplantation Group. Chest 105:343–348PubMedCrossRef Carre P, Rousseau H, Lombart L et al (1994) Balloon dilatation and self-expanding metal Wallstent insertion for management of bronchostenosis following lung transplantation. The Toulouse Lung Transplantation Group. Chest 105:343–348PubMedCrossRef
23.
go back to reference Kim JH, Shin JH, Song HY (2010) Benign strictures of the esophagus and gastric outlet: interventional management. Korean J Radiol 11:497–506PubMedCrossRef Kim JH, Shin JH, Song HY (2010) Benign strictures of the esophagus and gastric outlet: interventional management. Korean J Radiol 11:497–506PubMedCrossRef
24.
go back to reference Kim JH, Shin JH, Song HY, Lee SC, Kim KR, Park JH (2008) Use of a retrievable metallic stent internally coated with silicone to treat airway obstruction. J Vasc Interv Radiol 19:1208–1214PubMedCrossRef Kim JH, Shin JH, Song HY, Lee SC, Kim KR, Park JH (2008) Use of a retrievable metallic stent internally coated with silicone to treat airway obstruction. J Vasc Interv Radiol 19:1208–1214PubMedCrossRef
25.
go back to reference Kim JH, Shin JH, Song HY et al (2010) Cutting balloon treatment for resistant benign bronchial strictures: report of eleven patients. J Vasc Interv Radiol 21:748–752PubMedCrossRef Kim JH, Shin JH, Song HY et al (2010) Cutting balloon treatment for resistant benign bronchial strictures: report of eleven patients. J Vasc Interv Radiol 21:748–752PubMedCrossRef
26.
go back to reference Sacks D, McClenny TE, Cardella JF, Lewis CA (2003) Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202PubMedCrossRef Sacks D, McClenny TE, Cardella JF, Lewis CA (2003) Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol 14:S199–S202PubMedCrossRef
27.
go back to reference Ryu YJ, Kim H, Yu CM et al (2006) Comparison of natural and Dumon airway stents for the management of benign tracheobronchial stenoses. Respirology 11:748–754PubMedCrossRef Ryu YJ, Kim H, Yu CM et al (2006) Comparison of natural and Dumon airway stents for the management of benign tracheobronchial stenoses. Respirology 11:748–754PubMedCrossRef
28.
go back to reference Kim JH, Shin JH, Song HY, Shim TS, Yoon CJ, Ko GY (2007) Benign tracheobronchial strictures: long-term results and factors affecting airway patency after temporary stent placement. AJR Am J Roentgenol 188:1033–1038PubMedCrossRef Kim JH, Shin JH, Song HY, Shim TS, Yoon CJ, Ko GY (2007) Benign tracheobronchial strictures: long-term results and factors affecting airway patency after temporary stent placement. AJR Am J Roentgenol 188:1033–1038PubMedCrossRef
29.
go back to reference Dooms C, De Keukeleire T, Janssens A, Carron K (2009) Performance of fully covered self-expandable metallic stents in benign airway strictures. Respiration 77:420–426PubMedCrossRef Dooms C, De Keukeleire T, Janssens A, Carron K (2009) Performance of fully covered self-expandable metallic stents in benign airway strictures. Respiration 77:420–426PubMedCrossRef
30.
go back to reference Park HY, Kim H, Koh WJ, Suh GY, Chung MP, Kwon OJ (2009) Natural stent in the management of post-intubation tracheal stenosis. Respirology 14:583–588PubMedCrossRef Park HY, Kim H, Koh WJ, Suh GY, Chung MP, Kwon OJ (2009) Natural stent in the management of post-intubation tracheal stenosis. Respirology 14:583–588PubMedCrossRef
31.
go back to reference Nouraei SA, Ghufoor K, Patel A, Ferguson T, Howard DJ, Sandhu GS (2007) Outcome of endoscopic treatment of adult postintubation tracheal stenosis. Laryngoscope 117:1073–1079PubMedCrossRef Nouraei SA, Ghufoor K, Patel A, Ferguson T, Howard DJ, Sandhu GS (2007) Outcome of endoscopic treatment of adult postintubation tracheal stenosis. Laryngoscope 117:1073–1079PubMedCrossRef
Metadata
Title
Fluoroscopically Guided Balloon Dilation for Postintubation Tracheal Stenosis
Authors
Woong Hee Lee
Jin Hyoung Kim
Jung-Hun Park
Publication date
01-10-2013
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 5/2013
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-013-0556-8

Other articles of this Issue 5/2013

CardioVascular and Interventional Radiology 5/2013 Go to the issue