PMID- 30910657
OWN - NLM
STAT- MEDLINE
DCOM- 20200116
LR  - 20200116
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 108
IP  - 3
DP  - 2019 Sep
TI  - Long-Term Outcome of Metallic Stenting for Central Airway Involvement in 
      Relapsing Polychondritis.
PG  - 897-904
LID - S0003-4975(19)30389-3 [pii]
LID - 10.1016/j.athoracsur.2019.02.039 [doi]
AB  - BACKGROUND: Placement of uncovered self-expandable metallic stents was found to 
      successfully alleviate critical airflow limitation in patients with relapsing 
      polychondritis (RP) with central airway involvement by several reports. However, 
      the long-term outcome of airway metallic stenting in patients with RP remain 
      unclear. METHODS: We retrospectively analyzed patients with RP who underwent 
      airway metallic stenting with the use of fiberoptic bronchoscopy between 
      September 1, 2009, and October 1, 2017, in Shanghai. Outcome measurements, 
      including modified Medical Research Council (mMRC) dyspnea score, 6-minute walk 
      distance (6MWD), spirometry, and bronchoscopic findings, as well as adverse 
      events after stent placement, were collected. RESULTS: A total of 27 patients 
      were included; the median patient age was 58 years (range: 41 to 74 years), and 
      19 were men (70.4%). Nineteen uncovered self-expandable metallic stents were 
      placed in the trachea and 39 in the main bronchi. The median follow-up time was 
      50.5 months (range: 6 to 100 months). The baseline forced expiratory volume in 1 
      second (FEV(1)) percentage predicted (%pred), FEV(1)/forced vital capacity (FVC), 
      and peak expiratory flow (PEF) was 24.2 +/- 3.7, 27.2 +/- 5.6, and 0.99 +/- 0.21 L/min, 
      respectively. One day after the procedure, improvement from baseline in FEV(1) 
      %pred, FEV(1)/FVC, and PEF was 17.9 +/- 8.9 (p = 0.001), 19.8 +/- 10.9 (p = 0.002), 
      and 0.69 +/- 0.44 L/min (p = 0.001), respectively. Changes in the following 
      variables were also statistically and clinically significant: 6MWD of 193.7 +/- 
      83.4 m; mMRC dyspnea score of -1.2 +/- 0.4 points (both p < 0.05). The improvements 
      were maintained at 5 years: a mean change in FEV(1) %pred, FEV(1)/FVC, PEF, 6MWD, 
      and mMRC score was 19.5 +/- 6.7, 13.9 +/- 5.0, 0.82 +/- 0.40 L/min, 134.7 +/- 66.2 m, 
      and -0.83 +/- 0.29 points, respectively. Cough, foreign body sensation, mucus 
      production, and granulomas were common adverse events, occurring in 48.1% (13 of 
      27), 40.7% (11 of 27), 29.6% (8 of 27), and 25.9% (7 of 27) of the subjects. 
      However, none of those complications were severe enough to require urgent 
      bronchoscopic interventions. CONCLUSIONS: Airway metallic stenting in patients 
      with RP with central airway involvement resulted in long-term clinical benefits 
      in lung function, exercise tolerance, and dyspnea with an acceptable safety 
      profile.
CI  - Copyright (c) 2019 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Wu, Xiaodong
AU  - Wu X
AD  - Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, 
      Tongji University, Shanghai, China.
FAU - Zhang, Xin
AU  - Zhang X
AD  - Department of Respiratory and Critical Care Medicine, Changhai Hospital, the 
      Second Military Medical University, Shanghai, China.
FAU - Zhang, Wei
AU  - Zhang W
AD  - Department of Respiratory and Critical Care Medicine, Changhai Hospital, the 
      Second Military Medical University, Shanghai, China.
FAU - Huang, Haidong
AU  - Huang H
AD  - Department of Respiratory and Critical Care Medicine, Changhai Hospital, the 
      Second Military Medical University, Shanghai, China.
FAU - Li, Qiang
AU  - Li Q
AD  - Department of Respiratory and Critical Care Medicine, Shanghai East Hospital, 
      Tongji University, Shanghai, China; Department of Respiratory and Critical Care 
      Medicine, Changhai Hospital, the Second Military Medical University, Shanghai, 
      China. Electronic address: liqressh@hotmail.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190322
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
RN  - 0 (Metals)
SB  - IM
MH  - Adult
MH  - Airway Obstruction/diagnostic imaging/etiology/*surgery
MH  - Bronchoscopy/*methods
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Metals
MH  - Middle Aged
MH  - Patient Safety
MH  - Polychondritis, Relapsing/complications/*diagnostic imaging/*surgery
MH  - Prosthesis Design
MH  - Prosthesis Implantation
MH  - *Quality of Life
MH  - Respiratory Function Tests
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - *Stents
MH  - Time Factors
MH  - Tomography, X-Ray Computed/methods
MH  - Treatment Outcome
MH  - Vital Capacity/physiology
EDAT- 2019/03/27 06:00
MHDA- 2020/01/17 06:00
CRDT- 2019/03/27 06:00
PHST- 2018/06/24 00:00 [received]
PHST- 2019/02/13 00:00 [revised]
PHST- 2019/02/19 00:00 [accepted]
PHST- 2019/03/27 06:00 [pubmed]
PHST- 2020/01/17 06:00 [medline]
PHST- 2019/03/27 06:00 [entrez]
AID - S0003-4975(19)30389-3 [pii]
AID - 10.1016/j.athoracsur.2019.02.039 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2019 Sep;108(3):897-904. doi: 10.1016/j.athoracsur.2019.02.039. 
      Epub 2019 Mar 22.