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Robin T, Robin E, Le Boedec K. A systematic review and meta-analysis of prevalence of complications after tracheal stenting in dogs. J Vet Intern Med 2024; 38:2034-2044. [PMID: 38822531 PMCID: PMC11256162 DOI: 10.1111/jvim.17117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 05/07/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Stenting has become popular to treat tracheal collapse in dogs, but complications might arise and negatively affect treatment outcome. OBJECTIVES Determine the overall prevalence of complications of tracheal stenting in dogs. METHODS A bibliographic search was performed of publications from 2000 to 2020. Studies were assessed for quality of evidence and measured prevalence of the 8 most commonly reported complications after tracheal stenting in dogs (stent fracture, stent migration, relapsing collapse, granuloma formation, tracheobronchial infections, and early, late, and clinically relevant late cough). Random effects meta-analyses were used to estimate pooled complications prevalence. RESULTS Fifteen studies met inclusion criteria. Cough (early: 99%; 95% confidence interval [95% CI]: 95%-100%, late: 75%; 95% CI: 63%-85%, and clinically relevant: 52%; 95% CI: 42%-61%), tracheobronchial infections (24%; 95% CI: 14%-35%), and granulomas (20%; 95% CI: 11%-30%) were common after tracheal stenting. Stent fractures (12%; 95% CI: 5%-20%), relapsing collapse (10%; 95% CI: 5%-15%), and stent migration (5%; 95% CI: 1%-9%) were less frequent. Significant heterogeneity among studies was identified for the estimated prevalence of stent fracture, granulomas, infections, and late cough. CONCLUSIONS AND CLINICAL IMPORTANCE Tracheal stenting in dogs is associated with a high risk of coughing and a moderate risk of tracheobronchial infections and granuloma formation. Because most complications will impact a dog's quality of life, owners must be informed that tracheal stenting is a second-line procedure that does not necessarily alleviate the need for medical treatment and frequent follow-up visits. Additional studies are warranted to identify the risk factors of these complications.
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Affiliation(s)
- Thibaud Robin
- Internal Medicine Unit, Centre Hospitalier Vétérinaire Frégis, IVC Evidensia FranceParisFrance
| | - Elisabeth Robin
- Internal Medicine Unit, Centre Hospitalier Vétérinaire Frégis, IVC Evidensia FranceParisFrance
| | - Kevin Le Boedec
- Internal Medicine Unit, Centre Hospitalier Vétérinaire Frégis, IVC Evidensia FranceParisFrance
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2
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Kelly D, Juvet F, Lamb V, Holdsworth A. Bronchial collapse and bronchial stenting in 9 dogs. J Vet Intern Med 2023; 37:2460-2467. [PMID: 37695258 PMCID: PMC10658526 DOI: 10.1111/jvim.16859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 08/24/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Principal and lobar bronchial collapse is increasingly recognized as an isolated entity. OBJECTIVE Retrospectively describe the procedure and outcomes of dogs undergoing bronchial stenting at a single referral hospital. ANIMALS Nine client-owned dogs with variable degrees of collapse of the left principal bronchus (LPB), lobar bronchus 1 (LB1), and lobar bronchus 2 (LB2), and with clinically relevant signs of respiratory dysfunction. METHODS Data were collected from patient records. All dogs underwent stenting of the LPB and LB2. Anatomic and functional impairment grades were assigned to each case before and 4 weeks after stenting. Data regarding response to stenting and complications were evaluated. RESULTS Bronchial stenting was considered successful in all cases, with all dogs experiencing improved quality of life (QOL), and decreased functional impairment grade at 4 weeks post-stenting. Follow-up of >6 months was available for 6 dogs and of these, 5 were alive at 12 months, 3 were alive at 18 months, and 1 was alive at 24 months. Stent-related complications occurred in 4 dogs, and were resolvable in 3. Two dogs developed pneumothorax, 1 developed recurrent pneumonia, and 1 developed new-onset coughing. All dogs had mild and manageable coughing post-stenting. CONCLUSIONS AND CLINICAL IMPORTANCE Stenting of the LBP and LB2 might be an effective option for dogs with advanced collapse of these bronchi and associated signs. Although all included dogs had resolution or improvement of clinical signs considered life-threatening or as affecting QOL, ongoing coughing is expected. Patient selection appears important with regard to achieving successful outcomes.
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Affiliation(s)
- Darren Kelly
- Southern Counties Veterinary SpecialistsRingwoodUnited Kingdom
| | - Florence Juvet
- Southern Counties Veterinary SpecialistsRingwoodUnited Kingdom
| | - Valerie Lamb
- Southern Counties Veterinary SpecialistsRingwoodUnited Kingdom
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Graczyk S, Pasławski R, Grzeczka A, Pasławska U, Świeczko-Żurek B, Malisz K, Popat K, Sionkowska A, Golińska P, Rai M. Antimicrobial and Antiproliferative Coatings for Stents in Veterinary Medicine-State of the Art and Perspectives. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6834. [PMID: 37959431 PMCID: PMC10649059 DOI: 10.3390/ma16216834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023]
Abstract
Microbial colonization in veterinary stents poses a significant and concerning issue in veterinary medicine. Over time, these pathogens, particularly bacteria, can colonize the stent surfaces, leading to various complications. Two weeks following the stent insertion procedure, the colonization becomes observable, with the aggressiveness of bacterial growth directly correlating with the duration of stent placement. Such microbial colonization can result in infections and inflammations, compromising the stent's efficacy and, subsequently, the animal patient's overall well-being. Managing and mitigating the impact of these pathogens on veterinary stents is a crucial challenge that veterinarians and researchers are actively addressing to ensure the successful treatment and recovery of their animal patients. In addition, irritation of the tissue in the form of an inserted stent can lead to overgrowth of granulation tissue, leading to the closure of the stent lumen, as is most often the case in the trachea. Such serious complications after stent placement require improvements in the procedures used to date. In this review, antibacterial or antibiofilm strategies for several stents used in veterinary medicine have been discussed based on the current literature and the perspectives have been drawn. Various coating strategies such as coating with hydrogel, antibiotic, or other antimicrobial agents have been reviewed.
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Affiliation(s)
- Szymon Graczyk
- Institute of Veterinary Medicine, Department of Biological and Veterinary Sciences, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland; (R.P.); (A.G.); (U.P.)
| | - Robert Pasławski
- Institute of Veterinary Medicine, Department of Biological and Veterinary Sciences, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland; (R.P.); (A.G.); (U.P.)
| | - Arkadiusz Grzeczka
- Institute of Veterinary Medicine, Department of Biological and Veterinary Sciences, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland; (R.P.); (A.G.); (U.P.)
| | - Urszula Pasławska
- Institute of Veterinary Medicine, Department of Biological and Veterinary Sciences, Nicolaus Copernicus University, Lwowska 1, 87-100 Torun, Poland; (R.P.); (A.G.); (U.P.)
| | - Beata Świeczko-Żurek
- Department of Biomaterials Technology, Faculty of Mechanical Engineering and Ship Technology, Gdansk University of Technology, Gabriela Narutowicza 11/12, 80-229 Gdansk, Poland; (B.Ś.-Ż.); (K.M.)
| | - Klaudia Malisz
- Department of Biomaterials Technology, Faculty of Mechanical Engineering and Ship Technology, Gdansk University of Technology, Gabriela Narutowicza 11/12, 80-229 Gdansk, Poland; (B.Ś.-Ż.); (K.M.)
| | - Ketul Popat
- Department of Mechanical Engineering, Colorado State University, Fort Collins, CO 80523, USA;
| | - Alina Sionkowska
- Department of Biomaterials and Cosmetic Chemistry, Faculty of Chemistry, Nicolaus Copernicus University in Torun, Gagarina 7, 87-100 Torun, Poland
| | - Patrycja Golińska
- Department of Microbiology, Nicolaus Copernicus University, ul. Lwowska 1, 87-100 Torun, Poland;
| | - Mahendra Rai
- Department of Chemistry, Federal University of Piaui (UFPI), Teresina 64049-550, Brazil;
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Kim JH, Choi JY, Yoon HY. Comparison of three different self-expanding metal stents using rabbit models for the treatment of tracheal collapse. Acta Cir Bras 2022; 37:e370502. [PMID: 35976340 PMCID: PMC9377205 DOI: 10.1590/acb370502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/14/2022] [Indexed: 11/22/2022] Open
Abstract
Purpose: To identify an optimal self-expandable metallic stent (SEMS) and verify whether a mechanically superior SEMS would result in better clinical outcomes in the treatment of tracheal collapse. Methods: We selected three SEMS (n = 8 each), including an S-type stent with a wire diameter of 0.006 inches (S6) and two D-type stents with wire diameters of 0.006 (D6) and 0.007 inches (D7). Twenty-four New Zealand White rabbits were divided into three equal groups. After the stents were deployed, the clinical signs were recorded daily, and radiographic examinations were performed monthly. All rabbits were euthanized after three months. Results: Two rabbits with S6 stents and one rabbit with a D7 stent died within three months because of stent migration or pneumonia. All rabbits with D6 stents survived for three months. On histological examination, the D6 group had the lowest inflammation score. Conclusions: Both clinically and histopathologically, the results with D-type stents with a wire diameter of 0.006 inches were superior to those of the other groups (p = 0.001). The use of an optimal intraluminal stent may improve the long-term clinical outcomes in the treatment of tracheal collapse in dogs.
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Affiliation(s)
- Ji-Hyun Kim
- DVM., PhD. Konkuk University - College of Veterinary Medicine - Department of Veterinary Surgery - Seoul, South Korea
| | - Jin-Young Choi
- DVM. Konkuk University - College of Veterinary Medicine - Department of Veterinary Surgery - Seoul, South Korea
| | - Hun-Young Yoon
- DVM., PhD. Konkuk University - College of Veterinary Medicine - KU Center for Animal Blood Medical Science - Department of Veterinary Surgery - Seoul, South Korea
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Tanaka M, Uemura A. Self-expanding tracheal stent placement in a cat with primary tracheal collapse. Vet Med Sci 2022; 8:1347-1351. [PMID: 35441501 PMCID: PMC9297796 DOI: 10.1002/vms3.813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A 12-year-old mixed-breed spayed female cat presented with dyspnoea, open-mouthed breathing, and cyanosis that was difficult to control with medical pharmacotherapy; the cat was diagnosed with the primary tracheal collapse of the neck and chest regions. The diagnosis was confirmed by dynamic chest radiography, tracheal endoscopy, and computed tomography (CT). Tracheal endoscopy and CT showed dropsy of the dorsal membranous wall over most of the trachea. A self-expanding Nitinol cross-and-hook braided stent was placed along the entire tracheal lumen using surgical X-ray fluoroscopy. Bacterial cultures in the trachea were negative. Dyspnoea disappeared immediately after the endotracheal stent was implanted. Although the long-term prognosis remains under observation, the short- to medium-term prognosis was very good. These results suggest that stenting may be useful in the treatment of primary tracheal collapse in cats.
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Affiliation(s)
- Masashi Tanaka
- Laboratory of Veterinary Surgery, Department of Clinical Veterinary Medicine, Division of Veterinary Research, Obihiro University of Agriculture and Veterinary Medicine, Obihiro-shi, Japan
| | - Akiko Uemura
- Laboratory of Veterinary Surgery, Department of Clinical Veterinary Medicine, Division of Veterinary Research, Obihiro University of Agriculture and Veterinary Medicine, Obihiro-shi, Japan
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6
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Uemura A, Ozai Y, Hamabe L, Yoshida T, Tanaka R. Surgical outcomes in dogs with tracheal collapse treated with a novel cross-and-hook braided endoluminal stent. J Vet Sci 2022; 23:e46. [PMID: 35618319 PMCID: PMC9149497 DOI: 10.4142/jvs.21282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/27/2022] [Accepted: 03/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background Stenting is an effective treatment option for tracheal collapse in dogs. Cross-braided tracheal stents are currently the norm in veterinary medicine, but cross-and-hook braided stents have recently been adopted in human medicine. We examined whether stents manufactured using this novel braiding technique provided additional advantages for the treatment of tracheal collapse in dogs. Objectives To evaluate the outcomes of cross-and-hook braided stent implantation in the treatment of tracheal collapse in dogs. Methods The medical records of 22 client-owned dogs that underwent luminal placement of cross-and-hook braided Fauna Stents for the treatment of tracheal collapse between January 2018 and July 2021 were examined and data on canine signalment, clinical signs, diagnostic test results, surgical outcomes, and postoperative complications were retrieved and analyzed statistically. Results Twenty-six stents were surgically implanted, with 20 dogs (90.9%) receiving one stent and the remaining two (9.1%) receiving two or more stents. All dogs survived the procedure. The median survival time at a median follow-up of 990 days was 879 days. At the final follow-up examination, loss or mild improvement of cough was observed in all dogs. Conclusions Compared with conventional lumen stents, the cross-and-hook braided Fauna Stent offered a higher survival rate and improved clinical symptoms in all patients. The results of this study suggest that the Fauna Stent may be a promising treatment option for dogs with tracheal collapse.
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Affiliation(s)
- Akiko Uemura
- Division of Veterinary Research, Department of Clinical Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan
| | - Yusuke Ozai
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan
| | - Lina Hamabe
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan
| | - Tomohiko Yoshida
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan
| | - Ryou Tanaka
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, Tokyo 183-8509, Japan
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Reinero CR, Masseau I. Lower airway collapse: Revisiting the definition and clinicopathologic features of canine bronchomalacia. Vet J 2021; 273:105682. [PMID: 34148610 DOI: 10.1016/j.tvjl.2021.105682] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 04/07/2021] [Accepted: 04/15/2021] [Indexed: 12/24/2022]
Abstract
Bronchomalacia (BM) is an inconsistently defined term in dogs, impairing understanding of clinical presentation, therapeutic response and prognosis. Herein the authors propose to clarify the definition of canine bronchomalacia (CBM) as regional to diffuse dynamic airway collapse of segmental and/or subsegmental bronchi with associated clinical signs due to airflow limitation. In contrast to tracheal collapse, mainstem bronchial collapse, and in some cases lobar collapse, CBM requires advanced imaging. Common co-morbid conditions (e.g., chronic bronchitis, mitral valve degenerative disease, etc.) should be identified during a comprehensive diagnostic evaluation. Current empiric treatments advocated in absence of clinical trials documenting efficacy in the dog warrant evaluation, as some (e.g., bronchodilators) may have detrimental effects in certain types of airway collapse in humans. There is no direct treatment for CBM, as defined above, but non-specific therapies and targeted treatment of co-morbid disease may improve clinical signs and quality of life. In this manuscript, the authors provide a review of the different types of airway collapse focusing on CBM, reviewing their definition and etiology, proposing a classification scheme, and discussing clinical signs, diagnostic testing, and treatment. Future studies should focus on both improving understanding of the etiology and natural disease progression of CBM and treatment trials.
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Affiliation(s)
- Carol R Reinero
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, 900 East Campus Drive, University of Missouri, Columbia, MO 65211, USA.
| | - Isabelle Masseau
- Department of Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Canada
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8
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Congiusta M, Weisse C, Berent AC, Tozier E. Comparison of short-, intermediate-, and long-term results between dogs with tracheal collapse that underwent multimodal medical management alone and those that underwent tracheal endoluminal stent placement. J Am Vet Med Assoc 2021; 258:279-289. [PMID: 33496623 DOI: 10.2460/javma.258.3.279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare short-, intermediate-, and long-term results between dogs with tracheal collapse (TC) that received multimodal medical management only and those that underwent tracheal endoluminal stent placement. ANIMALS 159 dogs with TC that underwent medical management only (MM group; n = 84) or were surgically managed by stent placement (SM group; 75). PROCEDURES Medical records of dogs with TC that underwent medical management only or stent placement at a referral hospital between September 1, 2009, and August 1, 2018, were reviewed. Data regarding signalment, information relevant to TC, and outcome were extracted from the records and aggregated into short-, intermediate-, and long-term follow-up periods for analysis. Descriptive data and median survival times (MSTs) were compared between the MM and SM groups. RESULTS Clinical signs of dogs in the MM group generally improved during the short term but regressed and worsened over time. The proportion of dogs with malformation-type TC that underwent stent placement (38/43 [88%]) was significantly greater than the proportion of dogs with traditional-type TC that underwent stent placement (37/107 [35%]). The MST from TC diagnosis was 3.7 years for the MM group and 5.2 years for the SM group. For dogs with severe disease, the MST was 12 days for medically managed dogs and 1,338 days for dogs that underwent stent placement. CONCLUSIONS AND CLINICAL RELEVANCE Multimodal medical management alleviated clinical signs for months to years in dogs with mild to moderate TC disease, but stent placement should be considered for dogs with severe disease.
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Costa MA, Di Palma S, Dennis R, Gomez Selgas A, Fernández Y. Complete resolution of diffuse inflammatory tracheal stenosis in a dog. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Stefano Di Palma
- Preclinical DevelopmentAptuit (Verona) an Evotec CompanyVeronaItaly
| | - Ruth Dennis
- Diagnostic ImagingAnimal Health TrustNewmarketSuffolkUK
| | | | - Yordan Fernández
- Small Animal Internal MedicineAnimal Health TrustNewmarketSuffolkUK
- Hospital Veterinario PucholMadridSpain
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Reinero C, Visser LC, Kellihan HB, Masseau I, Rozanski E, Clercx C, Williams K, Abbott J, Borgarelli M, Scansen BA. ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs. J Vet Intern Med 2020; 34:549-573. [PMID: 32065428 PMCID: PMC7097566 DOI: 10.1111/jvim.15725] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/30/2020] [Indexed: 01/01/2023] Open
Abstract
Pulmonary hypertension (PH), defined by increased pressure within the pulmonary vasculature, is a hemodynamic and pathophysiologic state present in a wide variety of cardiovascular, respiratory, and systemic diseases. The purpose of this consensus statement is to provide a multidisciplinary approach to guidelines for the diagnosis, classification, treatment, and monitoring of PH in dogs. Comprehensive evaluation including consideration of signalment, clinical signs, echocardiographic parameters, and results of other diagnostic tests supports the diagnosis of PH and allows identification of associated underlying conditions. Dogs with PH can be classified into the following 6 groups: group 1, pulmonary arterial hypertension; group 2, left heart disease; group 3, respiratory disease/hypoxia; group 4, pulmonary emboli/pulmonary thrombi/pulmonary thromboemboli; group 5, parasitic disease (Dirofilaria and Angiostrongylus); and group 6, disorders that are multifactorial or with unclear mechanisms. The approach to treatment of PH focuses on strategies to decrease the risk of progression, complications, or both, recommendations to target underlying diseases or factors contributing to PH, and PH‐specific treatments. Dogs with PH should be monitored for improvement, static condition, or progression, and any identified underlying disorder should be addressed and monitored simultaneously.
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Affiliation(s)
- Carol Reinero
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri
| | - Lance C Visser
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Heidi B Kellihan
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin
| | - Isabelle Masseau
- Department of Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Quebec, Canada
| | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, Medford, Massachusetts
| | - Cécile Clercx
- Department of Clinical Sciences of Companion Animals and Equine, University of Liège, Liège, Belgium
| | - Kurt Williams
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Jonathan Abbott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee
| | - Michele Borgarelli
- Department of Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine, Blacksburg, Virginia
| | - Brian A Scansen
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
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Lesnikowski S, Weisse C, Berent A, Le Roux A, Tozier E. Bacterial infection before and after stent placement in dogs with tracheal collapse syndrome. J Vet Intern Med 2020; 34:725-733. [PMID: 31977124 PMCID: PMC7096657 DOI: 10.1111/jvim.15712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 01/13/2020] [Indexed: 12/21/2022] Open
Abstract
Background Dogs with tracheal stents often have positive airway bacterial cultures. The pathogenicity of these organisms and risk factors for infection have not been investigated. Objective Describe bacterial infection in dogs with tracheal collapse before and after tracheal stent placement. Animals Fifty‐three client‐owned dogs. Methods Retrospective review of medical records of dogs receiving tracheal stents with thoracic radiographs, tracheoscopy, and endotracheal lavage. Results There was no difference between the overall prevalence of dogs with positive bacterial cultures before (31/38; 82%) or after stent placement (24/31; 77%) (P = .67). An increased number of geriatric (17/28; 61%) and traditional‐type collapse (TTC) (16/26; 62%) dogs had positive pathogenic airway infections before stent placement, compared to young (8/25; 32%; P = .04) and malformation‐type collapse (MTC) dogs (9/27; 33%; P = .04). After tracheal stent placement, geriatric dogs had a 52% reduction in pathogenic bacteria infection frequency (P = .02) and dogs with TTC had a 56% reduction in pathogenic bacteria infection frequency (P = .01). Significant risk factors for pathogenic infection included a history of pneumonia (OR = 3.6; 95% CI, 0.28‐43.36) and cardiac disease (OR = 1.25; 95% CI, 0.16‐9.92) in geriatric dogs, and hepatomegaly in young dogs (OR = 1.5; 95% CI, 0.12‐19.44). Conclusions and Clinical Importance Tracheal stent placement does not increase the overall rate of pathogenic bacterial infection in dogs with tracheal collapse and can decrease the rate of subsequent pathogenic infections in geriatric dogs and dogs with TTC that require tracheal stenting. Airway culture and cytology should be performed in all dogs undergoing tracheal stent placement.
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Affiliation(s)
| | | | | | | | - Erik Tozier
- Lamb Statistical Consulting LLC, West Saint Paul, Minnesota
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Abstract
Tracheal and airway collapse (bronchomalacia) are common causes of chronic cough in middle-aged to older dogs in which weakening of cartilage within the respiratory system leads to narrowing of airways, irritation, inflammation, partial to complete airway obstruction, and other secondary effects. Tracheomalacia occurs in small-breed dogs, whereas bronchomalacia can occur in any size dog. Successful treatment involves correct identification of the problem, recognition of concurrent disease processes, and appropriate medical therapy. Surgical intervention and intraluminal stenting are readily available so it is important to understand indications for such procedures.
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Affiliation(s)
- Ann Della Maggiore
- MarQueen Pet Emergency and Specialty Group, 9205 Sierra College Boulevard #120, Roseville, CA 95661, USA.
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Lopez-Minguez S, Serrano-Casorran C, Guirola JA, Rodriguez-Zapater S, Bonastre C, De Gregorio MA. New tracheal stainless steel stent pilot study: twelve month follow-up in a rabbit model. PeerJ 2019; 7:e7797. [PMID: 31608174 PMCID: PMC6788445 DOI: 10.7717/peerj.7797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/30/2019] [Indexed: 01/27/2023] Open
Abstract
Background Canine tracheal collapse is a complex airway pathology without promising treatment results. Currently nitinol stents are the best surgical option; however, some professionals are doubting if stent placement is the best option due to the associated complications. Objective Determine the technical feasibility, safety, and long-term follow-up after the implantation of a new tracheal stent designed for canine tracheal collapse. Methods Thirteen healthy, adult female New Zealander rabbits were involved in this pilot study.A new intra-tracheal device (Reference number 902711 patent registered as CasMin-Twine) was implanted in ten animals. Deployment was performed under general anesthesia, making a puncture incision via a 21 Gauge needle in the intra-tracheal space where the stent was introduced with a screwing process. The device was fixed to the tracheal wall with a non-absorbable suture. Computerized Tomography (CT) and an endoscopy to study structural abnormalities were performed after 30, 90 and 365 days after stent placement. Results Technical and clinical success was 100%. There was no significant change in behavior or respiratory disorders. CT studies showed no significant alterations. After the 30 days, 60% of the animals showed partial endothelization in the endoscopy study, and only one animal still presented partial endothelization after 12 months. Mucus accumulation was only present in 40% of cases and classified as low, without respiratory consequences. Only one animal presented a single granuloma at caudal stent tip. Conclusions This new tracheal stent (CasMin-Twine) is an effective and safe procedure with promising results, and also shows the possibility of removing the device after endothelization has been produced. New studies should be carried out to evaluate the effectiveness in patients with tracheomalacia. Clinical Significance/Impact This new product can give veterinarians a new option of treatment for this complicated pathology. Minimizing specific equipment for its deployment, CasMin-Twine will be more accessible for all professionals.
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Affiliation(s)
- Sandra Lopez-Minguez
- University of Zaragoza, GITMI Minimally Invasive Techniques Research Group, Zaragoza, Spain
| | - Carolina Serrano-Casorran
- University of Zaragoza, GITMI Minimally Invasive Techniques Research Group, Zaragoza, Spain.,Animal Pathology, University of Zaragoza, Zaragoza, Spain
| | - Jose A Guirola
- University of Zaragoza, GITMI Minimally Invasive Techniques Research Group, Zaragoza, Spain.,Pediatrics, Radiology and Phisical medicine, University of Zaragoza, Zaragoza, España.,Interventional Radiology Service, Lozano Blesa University Hospital Zaragoza, Spain
| | | | - Cristina Bonastre
- University of Zaragoza, GITMI Minimally Invasive Techniques Research Group, Zaragoza, Spain.,Animal Pathology, University of Zaragoza, Zaragoza, Spain
| | - Miguel Angel De Gregorio
- University of Zaragoza, GITMI Minimally Invasive Techniques Research Group, Zaragoza, Spain.,Pediatrics, Radiology and Phisical medicine, University of Zaragoza, Zaragoza, España.,Interventional Radiology Service, Lozano Blesa University Hospital Zaragoza, Spain
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Violette NP, Weisse C, Berent AC, Lamb KE. Correlations among tracheal dimensions, tracheal stent dimensions, and major complications after endoluminal stenting of tracheal collapse syndrome in dogs. J Vet Intern Med 2019; 33:2209-2216. [PMID: 31290188 PMCID: PMC6766514 DOI: 10.1111/jvim.15555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 06/25/2019] [Indexed: 11/30/2022] Open
Abstract
Background Endoluminal tracheal stenting can relieve signs associated with tracheal collapse syndrome (TCS) in dogs, but major complications can result. Objective To identify associations among tracheal dimensions, stent dimensions, and subsequent complications requiring additional stent placement after endoluminal stenting for TCS. Animals Fifty‐two dogs from the hospital population. Methods Medical records of dogs that received an endoluminal self‐expanding tracheal stent for TCS by the interventional radiology service between 2009 and 2014 were reviewed for relevant data. Signalment and clinical details, including tracheal collapse type, tracheal measurements, nominal stent dimensions, follow‐up evaluation times, and stent complications, were recorded. Results Fifty‐two dogs that received an endoluminal stent for TCS met the inclusion criteria. Major complications included stent fracture (13/52; 25%), obstructive tissue ingrowth (10/52; 19%), and progressive tracheal collapse (6/52; 12%). Natural tracheal taper (P = .04) and more stent diameter oversizing (P = .04) in the intrathoracic (IT) trachea were associated with caudodorsal stent fracture. Only stents with a 14‐mm nominal diameter fractured. Progressive tracheal collapse was associated with smaller maximum tracheal diameters (P = .02). The majority of dogs with obstructive tissue ingrowth (7/10; 70%; P = .30) and all dogs with thoracic inlet fractures (3/3; 100%) had tracheal malformations. Conclusions and Clinical Importance A higher taper in tracheal diameter may lead to increased risk of fracture in the IT location. Dogs with tracheal malformations may have higher risk for thoracic inlet fracture and development of obstructive tissue ingrowth. Clinicians should be aware of the possible risk factors for tracheal stent complications.
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Affiliation(s)
- Nathaniel P Violette
- Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York
| | - Chick Weisse
- Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York
| | - Allyson C Berent
- Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York
| | - Kenneth E Lamb
- Lamb Statistical Consulting LLC, West St. Paul, Minnesota
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15
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Weisse C, Berent A, Violette N, McDougall R, Lamb K. Short-, intermediate-, and long-term results for endoluminal stent placement in dogs with tracheal collapse. J Am Vet Med Assoc 2019; 254:380-392. [DOI: 10.2460/javma.254.3.380] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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16
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Hall EL, Baines EA, Baines SJ. Atypical lateral tracheal collapse in a Yorkshire terrier. J Small Anim Pract 2018; 61:644-647. [PMID: 30387494 DOI: 10.1111/jsap.12954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 04/30/2018] [Accepted: 07/05/2018] [Indexed: 11/29/2022]
Abstract
A 10-month-old, neutered female Yorkshire terrier was presented with a 6-month history of inspiratory dyspnoea, coughing and exercise intolerance. Tracheoscopy revealed marked lateral-to-lateral fixed collapse of the cervical trachea and mild collapse of the thoracic trachea. Surgical exploration revealed a marked reduction in lateral tracheal width and multiple malformed tracheal rings. Placement of extraluminal ring prostheses around the cervical trachea resulted in widening of the tracheal diameter and an immediate improvement in clinical signs. 6 years postoperatively the patient was reported to have an excellent quality of life with complete resolution of clinical signs.
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Affiliation(s)
- E L Hall
- Department of Soft Tissue Surgery, Willows Veterinary Centre and Referral Service, Solihull, West Midlands, B90 4NH, UK
| | - E A Baines
- Department of Diagnostic Imaging, Willows Veterinary Centre and Referral Service, Solihull, West Midlands, B90 4NH, UK
| | - S J Baines
- Department of Soft Tissue Surgery, Willows Veterinary Centre and Referral Service, Solihull, West Midlands, B90 4NH, UK
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17
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Delaune T, Bernard F, Matres-Lorenzo L, Bernardé A. Radical cystectomy and subsequent ureterohysterostomy in a bitch. Vet Surg 2018; 47:1106-1111. [PMID: 30267416 DOI: 10.1111/vsu.12950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 06/12/2018] [Accepted: 07/18/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe and report the outcome of a ureterouterine anastomosis after unilateral dehiscence of a ureterovaginal anastomosis after total cystectomy in a bitch. STUDY DESIGN Case report. ANIMAL A 10-year-old intact female border collie with a urinary bladder leiomyosarcoma. METHODS The dog was diagnosed with an invasive urinary bladder tumor, treated by radical cystectomy and bilateral ureterovaginal anastomosis. Postoperative necrosis of the distal ureter led to dehiscence of the anastomosis on the right side. To preserve the right kidney, the right ureter was anastomosed to the right uterine horn, and a stent was placed across the uterine cervix. RESULTS The dog recovered from surgery and regained satisfactory urine output. Both ureteral anastomoses were patent at 10 months postoperatively. At 12 months postoperatively, intraluminal obstruction of the uterine stent, loss of patency of the right ureter, and severe right renal hydronephrosis were noted. The owner declined nephrectomy, and the dog died 2 months later. CONCLUSION This is the first published report of a ureterouterine anastomosis and stenting of the uterine cervix in a dog. The functional outcome was satisfactory for 1 year postoperatively. The uterine stent and distal ureter were eventually obstructed by soft tissue. CLINICAL SIGNIFICANCE Ureterouterine anastomosis can be considered as a salvage procedure when other surgical techniques have failed.
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Affiliation(s)
- Tiare Delaune
- Centre Hospitalier Vétérinaire St Martin, St Martin Bellevue, France
| | - Fabrice Bernard
- Centre Hospitalier Vétérinaire St Martin, St Martin Bellevue, France
| | | | - Antoine Bernardé
- Centre Hospitalier Vétérinaire St Martin, St Martin Bellevue, France
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18
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Clarke DL. Interventional Radiology Management of Tracheal and Bronchial Collapse. Vet Clin North Am Small Anim Pract 2018; 48:765-779. [DOI: 10.1016/j.cvsm.2018.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Kim H, Kim YJ, Lee H, An T, Yu J, Yoon H, An G, Jung J, Chang J, Chang D. Computed tomographic and radiographic bronchial collapse may be a normal characteristic of forced expiration in dogs. Vet Radiol Ultrasound 2018; 59:551-563. [PMID: 29786925 DOI: 10.1111/vru.12625] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/15/2018] [Accepted: 02/04/2018] [Indexed: 11/30/2022] Open
Abstract
Tracheobronchomalacia has been diagnosed using radiography or bronchoscopy to confirm bronchial changes in luminal diameter during the respiratory cycle. However, studies in healthy humans suggest that some degree of bronchial collapse may be observed during the normal respiratory cycle. In this analytical study, the luminal diameter of the bronchus to each of the six pulmonary lobes and the mean percentage of expiratory collapse from end inspiratory, end expiratory, and two forced expiratory phases (10 and 15 ml/kg) were determined via computed tomography (CT) and radiography in 22 healthy Beagle dogs. The bronchial collapsibility was significantly greater during the forced expiration than the end expiration (P < 0.001); the same results were observed in dorsal and sagittal CT images and radiographs (P < 0.001). Median collapsibility values associated with 15 ml/kg forced expiratory collapse determined via cross-sectional CT images were measured as 16.6-45.5% and differed according to the pulmonary lobe. Median collapsibilities on radiography with 15 ml/kg forced expiration were 57.8% and 62.1% in the right cranial lobe and right caudal lobe, respectively. In conclusion, bronchial diameter may change during the respiratory cycle, and some degree of reduction in bronchial diameter may be an incidental finding in healthy dogs. More rigorous criteria are needed with regards to bronchial collapsibility during normal respiration for the diagnosis of bronchomalacia in order to avoid false-positive diagnoses.
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Affiliation(s)
- Hyunryung Kim
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Young Joo Kim
- Western University of Health Science, College of Veterinary Medicine, Pomona, CA
| | - Hanbin Lee
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Taegeon An
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jin Yu
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Hyounglok Yoon
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Gayeon An
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jaihyun Jung
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jinhwa Chang
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Dongwoo Chang
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
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20
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Raske M, Weisse C, Berent AC, McDougall R, Lamb K. Immediate, short-, and long-term changes in tracheal stent diameter, length, and positioning after placement in dogs with tracheal collapse syndrome. J Vet Intern Med 2018; 32:782-791. [PMID: 29460368 PMCID: PMC5867008 DOI: 10.1111/jvim.15063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 10/10/2017] [Accepted: 01/16/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Intraluminal tracheal stenting is a minimally invasive procedure shown to have variable degrees of success in managing clinical signs associated with tracheal collapse syndrome (CTCS) in dogs. OBJECTIVES Identify immediate post-stent changes in tracheal diameter, determine the extent of stent migration, and stent shortening after stent placement in the immediate-, short-, and long-term periods, and evaluate inter-observer reliability of radiographic measurements. ANIMALS Fifty client-owned dogs. METHODS Retrospective study in which medical records were reviewed in dogs with CTCS treated with an intraluminal tracheal stent. Data collected included signalment, location, and type of collapse, stent diameter and length, and post-stent placement radiographic follow-up times. Radiographs were used to obtain pre-stent tracheal measurements and post-stent placement measurements. RESULTS Immediate mean percentage change was 5.14%, 5.49%, and 21.64% for cervical, thoracic inlet, and intra-thoracic tracheal diameters, respectively. Ultimate mean follow-up time was 446 days, with mean percentage change of 2.55%, 15.09%, and 8.65% for cervical, thoracic inlet, and intra-thoracic tracheal diameters, respectively. Initial mean stent length was 26.72% higher than nominal length and ultimate long-term tracheal mean stent shortening was only 9.90%. No significant stent migration was identified in the immediate, short-, or long-term periods. Good inter-observer agreement of radiographic measurements was found among observers of variable experience level. CONCLUSIONS AND CLINICAL IMPORTANCE Use of an intraluminal tracheal stent for CTCS is associated with minimal stent shortening with no clinically relevant stent migration after fluoroscopic placement. Precise stent sizing and placement techniques likely play important roles in avoiding these reported complications.
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Affiliation(s)
| | | | | | | | - Kenneth Lamb
- Lamb Statistical Consulting LLC, West St. Paul, Minnesota
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21
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Rosenheck S, Davis G, Sammarco CD, Bastian R. Effect of Variations in Stent Placement on Outcome of Endoluminal Stenting for Canine Tracheal Collapse. J Am Anim Hosp Assoc 2017; 53:150-158. [PMID: 28291400 DOI: 10.5326/jaaha-ms-6485] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The study's objective was to determine effects of relative size and placement location of endoluminal stents on incidence of complications and survival for canine tracheal collapse. Measurements were obtained on lateral radiographs before and after stenting to determine percent of the trachea occupied by the stent. These values were monitored over time and compared to complication rates and survival. Overall median survival time was 502 days. Six month survival rate was 78%, 1 yr survival was 60%, and 2 yr survival was 26%. Median percent of trachea occupied by the stent at initial placement was 79% (range, 41-93%). Percent of the trachea occupied by the stent at the time of placement did not significantly correlate to complication rate (0.397) or survival time (0.853). Incidence of serious complications was 37%, including granuloma formation, pneumonia, material failure, and stent migration. For patients experiencing serious complications, median survival was shorter, at 208 days, but was not significantly different from survival without serious complications. Within the margins of the data from this study, the proportion of the trachea occupied by the stent at the time of placement does not appear to impact incidence of complications or survival time in dogs with tracheal collapse.
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Affiliation(s)
- Stephanie Rosenheck
- From the Department of Surgery, Center For Animal Referral and Emergency Services, Langhorne, Pennsylvania (S.R.); Red Bank Veterinary Hospital, Tinton Falls, New Jersey (S.R., G.D., C.D.S.); and Monmouth University, West Long Branch, New Jersey (R.B.)
| | - Garrett Davis
- From the Department of Surgery, Center For Animal Referral and Emergency Services, Langhorne, Pennsylvania (S.R.); Red Bank Veterinary Hospital, Tinton Falls, New Jersey (S.R., G.D., C.D.S.); and Monmouth University, West Long Branch, New Jersey (R.B.)
| | - Carl D Sammarco
- From the Department of Surgery, Center For Animal Referral and Emergency Services, Langhorne, Pennsylvania (S.R.); Red Bank Veterinary Hospital, Tinton Falls, New Jersey (S.R., G.D., C.D.S.); and Monmouth University, West Long Branch, New Jersey (R.B.)
| | - Richard Bastian
- From the Department of Surgery, Center For Animal Referral and Emergency Services, Langhorne, Pennsylvania (S.R.); Red Bank Veterinary Hospital, Tinton Falls, New Jersey (S.R., G.D., C.D.S.); and Monmouth University, West Long Branch, New Jersey (R.B.)
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22
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Preston AR, Sullivan LA. Dislodgement of a right atrial thrombus and subsequent pulmonary thromboembolism following tracheal stent deployment in a dog. J Vet Emerg Crit Care (San Antonio) 2016; 26:809-814. [PMID: 27074582 DOI: 10.1111/vec.12459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 08/11/2014] [Accepted: 09/17/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To report the management of a dog that required 2 treatments with mechanical ventilation; firstly for severe tracheal collapse and secondly following deployment of a nitinol tracheal stent that immediately preceded a nonoxygen responsive pulmonary thromboembolism (PTE), suspected to have originated from the right atrium. CASE SUMMARY A 9-year-old female spayed Shetland Sheepdog was presented for management of a gallbladder mucocoele. Pertinent history included iatrogenic hyperadrenocorticism and tracheal collapse. The dog became clinical for tracheal collapse following laparoscopic cholecystectomy. Thoracic radiographs revealed moderate to severe tracheal collapse at the level of the thoracic inlet. Arterial blood gas was consistent with hypoventilation and mechanical ventilation was instituted. Given the severity of tracheal collapse, self-expanding nitinol tracheal stent placement was elected. Immediately following tracheal stent placement, the dog developed nonoxygen responsive hypoxemia requiring mechanical ventilation. Additional diagnostic tests revealed changes consistent with a PTE and a large thrombus in the right atrium. The dog was humanely euthanized. NEW OR UNIQUE INFORMATION PROVIDED Dislodgement of a preexisting atrial thrombus has not been described as a complication following tracheal stent deployment. Additionally, although PTE is frequently considered to be oxygen responsive, it may not be if the embolism is severe enough.
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Affiliation(s)
- Ayla R Preston
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Lauren A Sullivan
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO.
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23
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Williams JM, Krebs IA, Riedesel EA, Zhao Q. COMPARISON OF FLUOROSCOPY AND COMPUTED TOMOGRAPHY FOR TRACHEAL LUMEN DIAMETER MEASUREMENT AND DETERMINATION OF INTRALUMINAL STENT SIZE IN HEALTHY DOGS. Vet Radiol Ultrasound 2016; 57:269-75. [PMID: 26784924 DOI: 10.1111/vru.12344] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 11/09/2015] [Accepted: 11/11/2015] [Indexed: 11/27/2022] Open
Abstract
Tracheal collapse is a progressive airway disease that can ultimately result in complete airway obstruction. Intraluminal tracheal stents are a minimally invasive and viable treatment for tracheal collapse once the disease becomes refractory to medical management. Intraluminal stent size is chosen based on the maximum measured tracheal diameter during maximum inflation. The purpose of this prospective, cross-sectional study was to compare tracheal lumen diameter measurements and subsequent selected stent size using both fluoroscopy and CT and to evaluate inter- and intraobserver variability of the measurements. Seventeen healthy Beagles were anesthetized and imaged with fluoroscopy and CT with positive pressure ventilation to 20 cm H2 O. Fluoroscopic and CT maximum tracheal diameters were measured by three readers. Three individual measurements were made at eight predetermined tracheal sites for dorsoventral (height) and laterolateral (width) dimensions. Tracheal diameters and stent sizes (based on the maximum tracheal diameter + 10%) were analyzed using a linear mixed model. CT tracheal lumen diameters were larger compared to fluoroscopy at all locations (P-value < 0.0001). When comparing modalities, fluoroscopic and CT stent sizes were statistically different. Greater overall variation in tracheal diameter measurement (height or width) existed for fluoroscopy compared to CT, both within and among observers. The greater tracheal diameter measured with CT and lower measurement variability has clinical significance, as this may be the imaging modality of choice for appropriate stent selection to minimize complications in veterinary patients.
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Affiliation(s)
- Jackie M Williams
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, 50010
| | - Ingar A Krebs
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, 50010
| | - Elizabeth A Riedesel
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, 50010
| | - Qianqian Zhao
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, 53792
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24
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Tappin SW. Canine tracheal collapse. J Small Anim Pract 2016; 57:9-17. [DOI: 10.1111/jsap.12436] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/12/2015] [Accepted: 09/15/2015] [Indexed: 11/29/2022]
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25
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Tinga S, Thieman Mankin KM, Peycke LE, Cohen ND. Comparison of Outcome After Use of Extra-Luminal Rings and Intra-Luminal Stents for Treatment of Tracheal Collapse in Dogs. Vet Surg 2015; 44:858-65. [DOI: 10.1111/vsu.12365] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | | | | | - Noah D. Cohen
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station Texas
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26
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Beal MW. Tracheal stent placement for the emergency management of tracheal collapse in dogs. Top Companion Anim Med 2015; 28:106-11. [PMID: 24182999 DOI: 10.1053/j.tcam.2013.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Dogs with tracheal collapse may present with life-threatening upper airway obstruction. In most instances, a conservative approach to treatment including oxygen support coupled with sedation and cooling measures will relieve respiratory effort and thus relieve airway obstruction. Dogs that fail this conservative approach require endotracheal intubation to ensure a patent airway. This population of patients would benefit from a more definitive, yet palliative treatment option to acutely relieve upper airway obstruction. Placement of a self-expanding metallic stent that spans the affected portion of the trachea will acutely provide the patient with a sustained patent airway and optimize the likelihood of a positive outcome.
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Affiliation(s)
- Matthew W Beal
- Emergency and Critical Care Medicine Service and Interventional Radiology Services, Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.
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27
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Granone TD. Anesthesia case of the month. Iatrogenic pneumothorax. J Am Vet Med Assoc 2015; 246:189-92. [PMID: 25554932 DOI: 10.2460/javma.246.2.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Tiffany D Granone
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610
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28
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Montgomery JE, Mathews KG, Marcellin-Little DJ, Hendrick S, Brown JC. Comparison of Radiography and Computed Tomography for Determining Tracheal Diameter and Length in Dogs. Vet Surg 2014; 44:114-8. [DOI: 10.1111/j.1532-950x.2014.12227.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 05/01/2014] [Indexed: 11/28/2022]
Affiliation(s)
- James E. Montgomery
- Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon SK Canada
| | - Kyle G. Mathews
- College of Veterinary Medicine; North Carolina State University; Raleigh North Carolina
| | | | - Steve Hendrick
- Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon SK Canada
| | - James C. Brown
- College of Veterinary Medicine; North Carolina State University; Raleigh North Carolina
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29
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Weisse C. Insights in tracheobronchial stenting and a theory of bronchial compression. J Small Anim Pract 2014; 55:181-4. [DOI: 10.1111/jsap.12209] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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30
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Dengate A, Culvenor JA, Graham K, Braddock JA, Churcher RK. Bronchial stent placement in a dog with bronchomalacia and left atrial enlargement. J Small Anim Pract 2014; 55:225-8. [DOI: 10.1111/jsap.12183] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2013] [Indexed: 11/30/2022]
Affiliation(s)
- A. Dengate
- North Shore Veterinary Specialist Centre; Crows Nest NSW 2065 Australia
| | - J. A. Culvenor
- North Shore Veterinary Specialist Centre; Crows Nest NSW 2065 Australia
| | - K. Graham
- North Shore Veterinary Specialist Centre; Crows Nest NSW 2065 Australia
| | - J. A. Braddock
- North Shore Veterinary Specialist Centre; Crows Nest NSW 2065 Australia
| | - R. K. Churcher
- North Shore Veterinary Specialist Centre; Crows Nest NSW 2065 Australia
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31
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Abstract
Tracheal and airway collapse (bronchomalacia) are common causes of chronic cough in middle-aged to older dogs where weakening of cartilage within the respiratory system leads to narrowing of airways, coughing, wheezing, and other secondary effects. Successful treatment involves correct identification of the problem, recognition of concurrent problems, and appropriate medical therapy. Surgical and noninvasive treatment options are becoming readily available, and it is important to understand indications for such procedures.
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Affiliation(s)
- Ann Della Maggiore
- William R. Pritchard Veterinary Medical Teaching Hospital, University of California-Davis, Small Animal Internal Medicine, 1 Shields Avenue, Davis, CA 95616, USA.
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32
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Anesthetic and Airways Management of a Dog with Severe Tracheal Collapse during Intraluminal Stent Placement. Case Rep Vet Med 2013. [DOI: 10.1155/2013/234598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This case report describes the anesthetic and airways management of a dog affected by 4th degree tracheal collapse and undergoing endoscope-guided intraluminal stent placement. After premedication with acepromazine and butorphanol, general anesthesia was induced with propofol and maintained with intravenous propofol and butorphanol in constant rate infusion. During intraluminal stent placement, oxygen was supplemented by means of a simple and inexpensive handmade device, namely, a ureteral catheter inserted into the trachea and connected to an oxygen source, which allowed for the maintenance of airways’ patency and adequate patient’s oxygenation, without decreasing visibility in the surgical field or interfering with the procedure. The use of the technique described in the present paper was the main determinant of the successful anesthetic management and may be proposed for similar critical cases in which surgical manipulation of the tracheal lumen, which may potentially result in hypoxia by compromising airways patency, is required.
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33
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Durant AM, Sura P, Rohrbach B, Bohling MW. Use of nitinol stents for end-stage tracheal collapse in dogs. Vet Surg 2012; 41:807-17. [PMID: 22957667 DOI: 10.1111/j.1532-950x.2012.01037.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To report bronchoscopic placement of nitinol stents (Vet Stent-Trachea®) for improvement of end-stage clinical signs in dogs with tracheal collapse. STUDY DESIGN Case series. SAMPLE POPULATION Dogs (n = 18). METHODS Medical records (January 1, 2004-October 31, 2008) were searched for dogs with a diagnosis of tracheal collapse; 18 dogs met inclusion criteria. Tracheal diameter was compared before and after stent deployment. Stent dimensions were compared after stent deployment and at radiographic follow-up. RESULTS There was a significant difference in the minimum tracheal diameter when initial and post deployment tracheal diameters were compared (P = .003). Stent length was significantly shorter at follow-up when compared to post deployment measurements (P = .004). Owner assessment of outcome was available for all dogs with 11.1% mortality within 60 days. Complications were documented in 9 dogs. CONCLUSIONS Use of a nitinol stent (Vet Stent-Trachea®) in dogs with end-stage tracheal collapse is associated with a fair to good outcome despite significant temporal stent fore shortening after bronchoscopic placement.
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Affiliation(s)
- April M Durant
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN 37996, USA.
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Kim DH, Choi CB, Chung WH, Lee SH, Lee AJ, Jeong JS, Kim HJ, Kim HY. Preliminary study for a newly designed silicone stent and delivery system for canine obstructive tracheal disease. J Vet Med Sci 2012; 74:1323-6. [PMID: 22673748 DOI: 10.1292/jvms.11-0448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The goal of this study was to prove the possibility of using silicone stents broadly used for human medicine in canine obstructive tracheal disease. A silicone stent anatomically designed for canine trachea was tested on 5 beagle dogs for 8 weeks. The stent was carefully inserted using a newly developed delivery device under fluoroscopic guidance. There were no technical difficulties in placing the stent during the procedure. Previously reported complications of airway stenting such as stent migration or granulation tissue formation did not occur in any of the cases. In addition, removal of the stent was as simple as inserting it, and complications were absent. The stent introduced in this study could possibly be applied to various canine obstructive tracheal diseases.
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Affiliation(s)
- Dae-Hyun Kim
- Department of Veterinary Surgery, Collage of Veterinary Medicine, Konkuk University, 1 Hwayang-dong, Gwangjin-gu, Seoul, Korea
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Adamama-Moraitou KK, Pardali D, Day MJ, Prassinos NN, Kritsepi-Konstantinou M, Patsikas MN, Rallis TS. Canine bronchomalacia: A clinicopathological study of 18 cases diagnosed by endoscopy. Vet J 2012; 191:261-6. [DOI: 10.1016/j.tvjl.2010.11.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 11/15/2010] [Accepted: 11/18/2010] [Indexed: 10/18/2022]
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Adamama-Moraitou KK, Pardali D, Athanasiou LV, Prassinos NN, Kritsepi M, Rallis TS. Conservative management of canine tracheal collapse with stanozolol: a double blinded, placebo control clinical trial. Int J Immunopathol Pharmacol 2011; 24:111-8. [PMID: 21496393 DOI: 10.1177/039463201102400113] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
The objective of this study is to determine the efficacy of stanozolol in the treatment of tracheal collapse (TC) in dogs, which is the analogous disease to tracheomalacia (TM) in humans. Twenty-two dogs with endoscopically confirmed and graded TC were enrolled into five groups. Groups S1 (n=5), S2 (n=5) and S3 (n=4) with grade 1, 2 and 3 TC, respectively, received stanozolol orally for 75 days, while groups P1 (n=4) and P2 (n=4) with grade 1 and 2 TC, respectively, received placebo. The clinical score was evaluated every 15 days, whereas TC grade was reassessed at the end of the experiment. Clinical improvement was detected from the 30th day in S2 and S3 group dogs and from the 45th day in S1 group dogs and continued until the end of the experiment. Also, statistically significant differences were seen between S2 and P2 dogs from the 30th day, and between S1 and P1 dogs from the 60th day, and continued until the end of the study. Amelioration of the TC grade was seen in 13 of 14 (92.9%) dogs, which received stanozolol. Of the 14 dogs, 57.1% were cured and 35.8% demonstrated a less severe TC grade, while only one dog (7.1%) did not improve at all. Stanozolol seems to be an effective drug in the management of canine TC and it may have potential for use in humans with TM.
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Affiliation(s)
- K K Adamama-Moraitou
- Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Graham SB, Schilpp D, Bradley WM, Cook G, Gayle J. Treatment of traumatic tracheal collapse with extraluminal titanium mesh screens. EQUINE VET EDUC 2010. [DOI: 10.1111/j.2042-3292.2010.00126.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pardali D, Adamama-Moraitou K, Rallis T, Raptopoulos D, Gioulekas D. Tidal Breathing Flow-Volume Loop Analysis for the Diagnosis and Staging of Tracheal Collapse in Dogs. J Vet Intern Med 2010; 24:832-42. [DOI: 10.1111/j.1939-1676.2010.0513.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Busschers E, Epstein KL, Holt DE, Parente EJ. Extraluminal, C Shaped Polyethylene Prostheses in Two Ponies with Tracheal Collapse. Vet Surg 2010; 39:776-83. [DOI: 10.1111/j.1532-950x.2010.00715.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Johnson L, Pollard R. Tracheal Collapse and Bronchomalacia in Dogs: 58 Cases (7/2001-1/2008). J Vet Intern Med 2010; 24:298-305. [DOI: 10.1111/j.1939-1676.2009.0451.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Portier K, Viguier E. Fatal tracheal collapse in a dog with brachycephalic syndrome during gastric endoscopic examination. Vet Rec 2009; 165:412-4. [PMID: 19801596 DOI: 10.1136/vr.165.14.412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- K Portier
- Ecole Nationale Vétérinaire de Lyon, Marcy l'Etoile, France.
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Leonard CD, Johnson LR, Bonadio CM, Pollard RE. Changes in tracheal dimensions during inspiration and expiration in healthy dogs as detected via computed tomography. Am J Vet Res 2009; 70:986-91. [DOI: 10.2460/ajvr.70.8.986] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Weisse CW, Berent AC, Todd KL, Solomon JA. Potential applications of interventional radiology in veterinary medicine. J Am Vet Med Assoc 2008; 233:1564-74. [PMID: 19014289 DOI: 10.2460/javma.233.10.1564] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Chick W Weisse
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Ouellet M, Dunn ME, Lussier B, Chailleux N, Hélie P. Noninvasive correction of a fractured endoluminal nitinol tracheal stent in a dog. J Am Anim Hosp Assoc 2008; 42:467-71. [PMID: 17088395 DOI: 10.5326/0420467] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An 11-year-old, castrated male Pomeranian was presented for intractable cough and dyspnea secondary to severe tracheal collapse. An endoluminal nitinol tracheal stent was placed with good results. Five months following placement of the prosthesis, clinical signs acutely recurred and failure of the implant was noted. A second stent was superimposed over the fractured stent and resulted in resolution of all clinical signs. The dog died several months later from progression of the tracheal collapse to the carina and mainstem bronchi.
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Affiliation(s)
- Mathieu Ouellet
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, Quebec, J2S 7C6 Canada
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Kim JY, Han HJ, Yun HY, Lee B, Jang HY, Eom KD, Park HM, Jeong SW. The safety and efficacy of a new self-expandable intratracheal nitinol stent for the tracheal collapse in dogs. J Vet Sci 2008; 9:91-3. [PMID: 18296893 PMCID: PMC2839118 DOI: 10.4142/jvs.2008.9.1.91] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To evaluate the potential utility of a self-expandable intratracheal nitinol stent with flared ends for the treatment of tracheal collapse in dogs, endotracheal stenting therapy was performed under fluoroscopic guidance in four dogs with severe tracheal collapse. During the 4 to 7 month follow-up, after stent implantation, clinical signs, including dyspnea and respiratory distress, dramatically improved in all dogs. The radiographs showed that the implanted stents improved the tracheal collapse, and there were no side effects such as collapse, shortening or migration of the stents. In conclusion, the self-expandable intratracheal nitinol stents provided adequate stability to the trachea and were effective for attenuating the clinical signs associated with severe tracheal collapse.
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Affiliation(s)
- Joon-young Kim
- College of Veterinary Medicine, Konkuk University, Seoul 143-701, Korea
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Sun F, Usón J, Ezquerra J, Crisóstomo V, Luis L, Maynar M. Endotracheal stenting therapy in dogs with tracheal collapse. Vet J 2008; 175:186-93. [PMID: 17368061 DOI: 10.1016/j.tvjl.2007.01.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2005] [Revised: 10/03/2006] [Accepted: 01/27/2007] [Indexed: 11/19/2022]
Abstract
Tracheal collapse in dogs is a common respiratory disorder, typically presenting with a history of chronic cough, increasing respiratory difficulties, and episodes of dyspnoea. Medical treatment is the therapy of choice and surgical repair is considered when patients do not respond well. Minimally invasive endotracheal stenting is a promising new therapy under investigation, but there remain significant challenges to overcome potential complications. The purpose of this article is to provide a comparative overview of intra-luminal stenting of the trachea in human and veterinary medicine. The currently available stents and their potential clinical application to the veterinary patient will be discussed.
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Affiliation(s)
- Fei Sun
- Minimally Invasive Surgery Centre, Cáceres 10071, Spain.
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Sura PA, Krahwinkel DJ. Self-expanding nitinol stents for the treatment of tracheal collapse in dogs: 12 cases (2001–2004). J Am Vet Med Assoc 2008; 232:228-36. [DOI: 10.2460/javma.232.2.228] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Effective respiratory therapy depends on obtaining a definitive diagnosis and following established recommendations for treatment. Unfortunately, many respiratory conditions are idiopathic in origin or are attributable to nonspecific inflammation. In some situations, disorders are controlled rather than cured. Recent advances in pulmonary therapeutics include the use of new agents to treat common diseases and application of local delivery of drugs to enhance drug effect and minimize side effects.
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Affiliation(s)
- Elizabeth A Rozanski
- Section of Critical Care, Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA.
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