Bronchoscopic balloon dilatation of tracheobronchial stenosis: long-term follow-up

• Published in: European journal of cardio-thoracic surgery 2010-08, Vol.38 (2), p.198-202
• Main Authors: Shitrit, David, Kuchuk, Michael, Zismanov, Victoria, Rahman, Nader Abdel, Amital, Anat, Kramer, Mordechai R.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Balloon dilatation; Biological and medical sciences; Bronchial Diseases - physiopathology; Bronchial Diseases - therapy; Bronchoscopy; Cardiology. Vascular system; Catheterization - methods; Constriction, Pathologic - physiopathology; Constriction, Pathologic - therapy; Disease Progression; Endoscopy; Female; Follow-Up Studies; Forced Expiratory Volume; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Obstruction; Pneumology; Retrospective Studies; Stenosis; Stent; Stents; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Tracheal Stenosis - physiopathology; Tracheal Stenosis - therapy; Treatment Outcome; Vital Capacity
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/j.ejcts.2009.11.056

Objectives: Bronchoscopic balloon dilatation (BBD) has become a valuable tool in the treatment of tracheobronchial stenosis (TBS). The objective of this study was to assess the short- and long-term effects of BBD. Methods: A retrospective study that included all patients with confirmed, symptomatic stenosis, who underwent BBD between 2002 and 2008. A total of 92 BBD procedures were performed in 35 patients at our institute. Lung function studies were recorded for all patients before, immediately after and 1 month following the BBD. Long-term follow-up was for a mean of 33 ± 4 months. Results: All patients had initial success, including increased airway dimensions and symptom relief. No complications were noted related to BBD. Forced expiratory volume after one second (FEV1) was significantly increased after BBD (10.5%, p = 0.03). These effects persisted for at least 1 month. Long-term follow-up, however, demonstrated the need for stent placement in 25 of 35 patients (71%), 210 ± 91 days after BBD. Ten of 35 patients died 456 ± 119 days after BBD due to progression of primary disease; all deaths were unrelated to the BBD procedures. Conclusions: BBD is a safe method that offers immediate symptomatic relief in both tracheal and bronchial stenosis. However, BBD is a temporary measure, as many patients will require definitive or additional treatment with laser or stent placement.