Placement of self‐expanding metallic tracheobronchial Y stent with laryngeal mask airway using conscious sedation under fluoroscopic guidance
Abstract Background Central airway obstruction and fistula are treated with a tracheobronchial Y stent. In the currently used self‐expandable metal Y stents, the delivery system is 8 mm in diameter and requires either a 9 mm tracheal tube or rigid bronchoscope to enable airway control during inserti...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-02-01
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| Series: | Thoracic Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1759-7714.13782 |
| _version_ | 1819298566570508288 |
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| author | Barak Pertzov Evgeni Gershman Shimon Izhakian Shai M. Amor Dror Rosengarten Mordechai R. Kramer |
| author_facet | Barak Pertzov Evgeni Gershman Shimon Izhakian Shai M. Amor Dror Rosengarten Mordechai R. Kramer |
| author_sort | Barak Pertzov |
| collection | DOAJ |
| description | Abstract Background Central airway obstruction and fistula are treated with a tracheobronchial Y stent. In the currently used self‐expandable metal Y stents, the delivery system is 8 mm in diameter and requires either a 9 mm tracheal tube or rigid bronchoscope to enable airway control during insertion. In this study we present a novel technique of laryngeal mask airway (LMA) assisted Y stent insertion, enabling airway control during deployment of the Y stent. Methods All procedures using LMA in assisting Y stent insertions between 2014–2020 were reviewed. Data collected included demographics, clinical diagnosis and disease characteristics, indication, procedural success rates, clinical outcome and survival. Results A total of 10 patients with a median age of 61.5 years (range 37–73) underwent LMA assisted Y stent insertion. Indications for stent insertion were malignant disease with central airway obstruction or fistula. In all cases airway patency was achieved leading to improvement of symptoms and performance status. No procedural complications were reported. The median survival was 4.5 weeks (range: 2–26). Conclusions LMA assisted Y stent insertion enables airway control during the procedure. In comparison to silicone Y stent insertion, the procedure is less cumbersome, shorter in duration and does not require the use of general anesthesia or rigid bronchoscopy. Key points Significant findings of the study LMA assisted Y stent insertion enables airway control during the implantation of metallic self‐expanding Y stent. The procedure does not require the use of general anesthesia or rigid bronchoscopy. What this study adds In this study we present the technique and outcomes of LMA assisted Y stent insertion. This method of Y stent insertion provides an additional treatment option for patients with central airway obstruction and fistula. |
| first_indexed | 2024-12-24T05:31:56Z |
| format | Article |
| id | doaj.art-8ad266dac1f94e87a96ce0293b3a305a |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-12-24T05:31:56Z |
| publishDate | 2021-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-8ad266dac1f94e87a96ce0293b3a305a2022-12-21T17:13:08ZengWileyThoracic Cancer1759-77061759-77142021-02-0112448449010.1111/1759-7714.13782Placement of self‐expanding metallic tracheobronchial Y stent with laryngeal mask airway using conscious sedation under fluoroscopic guidanceBarak Pertzov0Evgeni Gershman1Shimon Izhakian2Shai M. Amor3Dror Rosengarten4Mordechai R. Kramer5The Pulmonary Division Rabin Medical Center Petach Tikva IsraelThe Pulmonary Division Rabin Medical Center Petach Tikva IsraelThe Pulmonary Division Rabin Medical Center Petach Tikva IsraelThe Pulmonary Division Rabin Medical Center Petach Tikva IsraelThe Pulmonary Division Rabin Medical Center Petach Tikva IsraelThe Pulmonary Division Rabin Medical Center Petach Tikva IsraelAbstract Background Central airway obstruction and fistula are treated with a tracheobronchial Y stent. In the currently used self‐expandable metal Y stents, the delivery system is 8 mm in diameter and requires either a 9 mm tracheal tube or rigid bronchoscope to enable airway control during insertion. In this study we present a novel technique of laryngeal mask airway (LMA) assisted Y stent insertion, enabling airway control during deployment of the Y stent. Methods All procedures using LMA in assisting Y stent insertions between 2014–2020 were reviewed. Data collected included demographics, clinical diagnosis and disease characteristics, indication, procedural success rates, clinical outcome and survival. Results A total of 10 patients with a median age of 61.5 years (range 37–73) underwent LMA assisted Y stent insertion. Indications for stent insertion were malignant disease with central airway obstruction or fistula. In all cases airway patency was achieved leading to improvement of symptoms and performance status. No procedural complications were reported. The median survival was 4.5 weeks (range: 2–26). Conclusions LMA assisted Y stent insertion enables airway control during the procedure. In comparison to silicone Y stent insertion, the procedure is less cumbersome, shorter in duration and does not require the use of general anesthesia or rigid bronchoscopy. Key points Significant findings of the study LMA assisted Y stent insertion enables airway control during the implantation of metallic self‐expanding Y stent. The procedure does not require the use of general anesthesia or rigid bronchoscopy. What this study adds In this study we present the technique and outcomes of LMA assisted Y stent insertion. This method of Y stent insertion provides an additional treatment option for patients with central airway obstruction and fistula.https://doi.org/10.1111/1759-7714.13782Central airwayfistulamalignantobstructionY stent |
| spellingShingle | Barak Pertzov Evgeni Gershman Shimon Izhakian Shai M. Amor Dror Rosengarten Mordechai R. Kramer Placement of self‐expanding metallic tracheobronchial Y stent with laryngeal mask airway using conscious sedation under fluoroscopic guidance Thoracic Cancer Central airway fistula malignant obstruction Y stent |
| title | Placement of self‐expanding metallic tracheobronchial Y stent with laryngeal mask airway using conscious sedation under fluoroscopic guidance |
| title_full | Placement of self‐expanding metallic tracheobronchial Y stent with laryngeal mask airway using conscious sedation under fluoroscopic guidance |
| title_fullStr | Placement of self‐expanding metallic tracheobronchial Y stent with laryngeal mask airway using conscious sedation under fluoroscopic guidance |
| title_full_unstemmed | Placement of self‐expanding metallic tracheobronchial Y stent with laryngeal mask airway using conscious sedation under fluoroscopic guidance |
| title_short | Placement of self‐expanding metallic tracheobronchial Y stent with laryngeal mask airway using conscious sedation under fluoroscopic guidance |
| title_sort | placement of self expanding metallic tracheobronchial y stent with laryngeal mask airway using conscious sedation under fluoroscopic guidance |
| topic | Central airway fistula malignant obstruction Y stent |
| url | https://doi.org/10.1111/1759-7714.13782 |
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