Bronchial stenting in infants with severe bronchomalacia: Technique and outcomes.


Journal

International journal of pediatric otorhinolaryngology
ISSN: 1872-8464
Titre abrégé: Int J Pediatr Otorhinolaryngol
Pays: Ireland
ID NLM: 8003603

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 06 03 2021
revised: 24 03 2021
accepted: 01 04 2021
pubmed: 29 4 2021
medline: 24 6 2021
entrez: 28 4 2021
Statut: ppublish

Résumé

To report the first use of a balloon expandable bare metal stent for treating infant bronchomalacia. Infant bronchomalacia often requires prolonged mechanical ventilation and can be life-threatening. Effective treatment for severe infant bronchomalacia continues to be elusive. We present three cases of bronchial stenting for no-option or treatment refractory infant bronchomalacia. Three consecutive cases of stenting to relieve conservative treatment refractory severe infant bronchomalacia were performed between February 2019 and December 2020. Initial diagnosis was confirmed with Computed Tomography (CT) angiography. Patients underwent rigid micro laryngoscopy, bronchoscopy, and flexible bronchoscopy to evaluate the airway. Initial conservative management strategies were pursued. Patients failing initial conservative management strategies were considered for rescue bronchial stenting. Our initial clinical experience with a coronary bare metal stent for these procedures has been favorable. The stent was easy to deploy with precision. We did not encounter stent embolization or migration. There was sufficient stent radial strength to relieve bronchomalacia without causing restenosis or erosion. There was no significant granulation tissue formation. In one patient, the stent was removed after 12 months of somatic growth; this was uneventful and bronchial patency was maintained. There were no complications in any of our patients regarding stent placement and reliability. In cases of three infants with severe bronchomalacia, we found that bronchial stenting with the bare metal coronary stent was effective in relieving bronchial stenosis.

Sections du résumé

OBJECTIVES OBJECTIVE
To report the first use of a balloon expandable bare metal stent for treating infant bronchomalacia.
BACKGROUND BACKGROUND
Infant bronchomalacia often requires prolonged mechanical ventilation and can be life-threatening. Effective treatment for severe infant bronchomalacia continues to be elusive. We present three cases of bronchial stenting for no-option or treatment refractory infant bronchomalacia.
METHODS METHODS
Three consecutive cases of stenting to relieve conservative treatment refractory severe infant bronchomalacia were performed between February 2019 and December 2020. Initial diagnosis was confirmed with Computed Tomography (CT) angiography. Patients underwent rigid micro laryngoscopy, bronchoscopy, and flexible bronchoscopy to evaluate the airway. Initial conservative management strategies were pursued. Patients failing initial conservative management strategies were considered for rescue bronchial stenting.
RESULTS RESULTS
Our initial clinical experience with a coronary bare metal stent for these procedures has been favorable. The stent was easy to deploy with precision. We did not encounter stent embolization or migration. There was sufficient stent radial strength to relieve bronchomalacia without causing restenosis or erosion. There was no significant granulation tissue formation. In one patient, the stent was removed after 12 months of somatic growth; this was uneventful and bronchial patency was maintained. There were no complications in any of our patients regarding stent placement and reliability.
CONCLUSION CONCLUSIONS
In cases of three infants with severe bronchomalacia, we found that bronchial stenting with the bare metal coronary stent was effective in relieving bronchial stenosis.

Identifiants

pubmed: 33910043
pii: S0165-5876(21)00096-3
doi: 10.1016/j.ijporl.2021.110703
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

110703

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Nikita Mittal (N)

Division of Pediatric Cardiology, Rady Children's Hospital and UC San Diego School of Medicine, 3020, Children's Way, San Diego, CA, USA.

Howaida G El-Said (HG)

Division of Pediatric Cardiology, Rady Children's Hospital and UC San Diego School of Medicine, 3020, Children's Way, San Diego, CA, USA.

Kanishka Ratnayaka (K)

Division of Pediatric Cardiology, Rady Children's Hospital and UC San Diego School of Medicine, 3020, Children's Way, San Diego, CA, USA.

Aparna Rao (A)

Division of Pediatric Pulmonology, Rady Children's Hospital and UC San Diego School of Medicine, 3020, Children's Way, San Diego, CA, USA.

Tzyynong L Friesen (TL)

Division of Pediatric Otolaryngology, Rady Children's Hospital and UC San Diego School of Medicine, 3020, Children's Way, San Diego, CA, USA.

John J Nigro (JJ)

Division of Pediatric Cardiology, Rady Children's Hospital and UC San Diego School of Medicine, 3020, Children's Way, San Diego, CA, USA.

Matthew T Brigger (MT)

Division of Pediatric Otolaryngology, Rady Children's Hospital and UC San Diego School of Medicine, 3020, Children's Way, San Diego, CA, USA. Electronic address: mbrigger@rchsd.org.

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