Clinical application of airway bypass with paclitaxel-eluting stents: Early results

Cardoso, Paulo F. G., Snell, Gregory I., Hopkins, Peter, Sybrecht, Gerhard W., Stamatis, Georgios, Ng, Alan W. and Eng, Philip (2007) Clinical application of airway bypass with paclitaxel-eluting stents: Early results. Journal of Thoracic and Cardiovascular Surgery, 134 4: 974-981. doi:10.1016/j.jtcvs.2007.05.040

Author Cardoso, Paulo F. G.
Snell, Gregory I.
Hopkins, Peter
Sybrecht, Gerhard W.
Stamatis, Georgios
Ng, Alan W.
Eng, Philip
Title Clinical application of airway bypass with paclitaxel-eluting stents: Early results
Journal name Journal of Thoracic and Cardiovascular Surgery   Check publisher's open access policy
ISSN 0022-5223
Publication date 2007-10
Sub-type Article (original research)
DOI 10.1016/j.jtcvs.2007.05.040
Volume 134
Issue 4
Start page 974
End page 981
Total pages 8
Place of publication Philadelphia, PA, United States
Publisher Mosby
Language eng
Formatted abstract
Objective: To assess the safety and early clinical results of a multicenter evaluation of airway bypass with paclitaxel-eluting stents for selected patients with severe emphysema.

Airway bypass was performed with a fiberoptic bronchoscope in three steps: identification of a blood vessel-free location with a Doppler probe at the level of segmental bronchi, fenestration of the bronchial wall, and placement of a paclitaxel-eluting stent to expand and maintain the new passage between the airway and adjacent lung tissue. All adverse events were recorded, as well as 1- and 6-month pulmonary function tests and dyspnea index.

Results: Thirty-five patients received the airway bypass procedure with a median of 8 stents implanted per patient. At 1-month follow-up, statistically significant differences in residual volume, total lung capacity, forced vital capacity, forced expiratory volume, modified Medical Research Council scale, 6-minute walk, and St George's Respiratory Questionnaire were observed. At the 6-month follow-up, statistically significant improvements in residual volume and dyspnea were demonstrated. One death occurred after bleeding during the procedure. Retrospective analysis revealed that the degree of pretreatment hyperinflation may be an important indicator of which patients achieve the best short- and long-term results.

Conclusions: The airway bypass procedure reduces hyperinflation and improves pulmonary function and dyspnea in selected patients with severe emphysema. Duration of benefit appears to correlate with the degree of pretreatment hyperinflation. These preliminary clinical results support further evaluation of the procedure.
Keyword Lung-Volume-Reduction
Collateral Ventilation
Severe Emphysema
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Issue section: "Evolving Technology". Early results. Read at the Eighty-sixth Annual Meeting of The American Association for Thoracic Surgery, Philadelphia, Pa, April 29–May 3, 2006.

Document type: Journal Article
Sub-type: Article (original research)
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