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Removal of Retrievable Self-Expandable Metallic Tracheobronchial Stents: An 18-Year Experience in a Single Center

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Abstract

Purpose

The purpose of the study was to retrospectively evaluate the technical outcomes of removal of retrievable self-expandable metallic stents (REMSs) and identify predictors of technical failure in 81 patients with benign and malignant tracheobronchial strictures.

Materials and Methods

A total of 98 REMSs were removed under fluoroscopic guidance in 81 patients with benign (n = 48) or malignant (n = 33) tracheobronchial strictures. Primary and secondary technical success rates and complication rate were evaluated. Technical outcomes with regard to underlying diseases were also evaluated. Logistic regression models were constructed to identify predictors of primary technical success.

Results

Primary and secondary technical success rates were 86.7 and 94.9 %, respectively. Stent removal-related complication rate was 7.1 % (7/98) and all were bleeding after stent removal. All bleeding complications were minor and managed conservatively. Primary technical success rate for benign strictures was significantly lower compared with that for malignant strictures (80.9 vs. 97.1 %, P = 0.029), but secondary technical success rate (93.7 vs. 97.1 %, P = 0.652) did not differ between the two groups. Granulation tissue formation was identified as an independent predictor of primary technical success (odds ratio 0.249, 95 % CI 0.071–0.874, P = 0.030).

Conclusion

Removal of REMSs in patients with benign and malignant tracheobronchial strictures is safe and technically feasible. Bronchoscopic guidance may be required when the removal using a hook wire fails. The presence of granulation tissue was the negative predictor of primary technical success.

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Acknowledgments

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and future Planning (2014R1A2A2A01005857).

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    Authors and Affiliations

    1. Departments of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap 2-dong, Songpa-gu, Seoul, 138-736, Republic of Korea

      Jung-Hoon Park, Pyeong Hwa Kim, Ji Hoon Shin, Jiaywei Tsauo, Min Tae Kim, Young Chul Cho, Jin Hyoung Kim & Ho-Young Song

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    1. Jung-Hoon Park
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    2. Pyeong Hwa Kim
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    3. Ji Hoon Shin
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    5. Min Tae Kim
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    6. Young Chul Cho
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    7. Jin Hyoung Kim
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    Correspondence to Ji Hoon Shin.

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    The authors declare that they have no conflict of interest.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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    For this type of study formal consent is not required.

    Additional information

    Jung-Hoon Park and Pyeong Hwa Kim contributed equally to this work as a first author.

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    Park, JH., Kim, P.H., Shin, J.H. et al. Removal of Retrievable Self-Expandable Metallic Tracheobronchial Stents: An 18-Year Experience in a Single Center. Cardiovasc Intervent Radiol 39, 1611–1619 (2016). https://doi.org/10.1007/s00270-016-1420-4

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    • DOI: https://doi.org/10.1007/s00270-016-1420-4

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