| Adverse impact of vascular stent "mass effect" on airways. | |
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MedLine Citation:
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PMID: 19213071 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To report our experience with bronchial compression secondary to vascular stent implantation within the mediastinum of patients with congenital heart disease. BACKGROUND: Stents are routinely used to correct native and postsurgical vessel stenoses. However, the "mass effect" of stents on adjacent structures within the chest has not been consistently appreciated nor evaluated. METHODS: A retrospective review of patients who had stent implantation and subsequent computerized tomographic angiography (CTA) at Rady Children's Hospital was performed. RESULTS: From August 2005 to November 2007, 147 stents were implanted to correct vessel stenoses within the chests of 120 patients. Among these 120 patients, 21 had CT angiograms performed after stent implantation. Clinical indications for poststent CT imaging included inability to wean from ventilator support, significant coughing episodes, continued hypoxia, and follow-up study after complex repairs. Six of the twenty one patients (29%) had adverse mass effects from stents causing compression of adjacent bronchial structures. Two of the six patients expired. One patient required a tracheostomy, two patients were slow to wean from the ventilator, while one was clinically asymptomatic. Five of the six patients had had an aortic arch anomaly with subsequent arch reconstruction or hybrid intervention. CONCLUSIONS: Stent implantation in vascular structures within the chest may have adverse mass effects on adjacent bronchial structures. Clinical sequelae may range from silent to catastrophic. Pre-and/or poststent implantation imaging of vascular structures and airways should be considered in selected patients. |
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Authors:
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Christine Ferandos; Howaida El-Said; Rabih Hamzeh; John W Moore |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 74 ISSN: 1522-726X ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-06-24 Completed Date: 2009-08-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 132-6 Citation Subset: IM |
Copyright Information:
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Copyright 2009 Wiley-Liss, Inc. |
Affiliation:
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Rady Children's Hospital, San Diego, California, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Airway Obstruction / etiology*, mortality, radiography, therapy Bronchial Diseases / etiology*, mortality, radiography, therapy Catheterization / adverse effects*, instrumentation, mortality Child Child, Preschool Constriction, Pathologic Female Heart Defects, Congenital / mortality, radiography, therapy* Humans Infant Infant, Newborn Male Retrospective Studies Stents / adverse effects* Tomography, X-Ray Computed Tracheostomy Treatment Outcome Vascular Malformations / mortality, radiography, therapy* Ventilator Weaning |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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