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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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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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3
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Graczyk S, Pasławski R, Grzeczka A, Litwińska L, Jagielski D, Pasławska U. Stents in Veterinary Medicine. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1480. [PMID: 36837110 PMCID: PMC9959717 DOI: 10.3390/ma16041480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Stenting in veterinary medicine has been a rapidly growing method of interventional surgery for several years. This procedure is usually performed in the respiratory and urinary tracts, but there are cases of stenting of blood vessels or gastrointestinal structures. It is based on maintaining the permeability of a given tubular structure, thus allowing the passage of gas or liquid. This procedure is often performed as a first-line treatment in situations where pharmacological agents do not work and as an alternative method, often cheaper than the classically performed ones. There are also cases where stenting is used as a palliative treatment, e.g., to enable defecation in colonic obstruction due to tumour infiltration of the colon wall. Stenting is often a life-saving or comfort-improving procedure for animals, but one should also be aware of possible postoperative complications and be prepared for any adversity. For this reason, this review provides an insight into the current knowledge in veterinary medicine about stenting and the consequences associated with this procedure.
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4
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Viñeta C, López MC, Verdés J, Roura X. Medical management of primary tracheal collapse in a cat. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Clàudia Viñeta
- Hospital Clínic Veterinari Universitat Autònoma de Barcelona Bellaterra Spain
| | | | - Judit Verdés
- Hospital Clínic Veterinari Universitat Autònoma de Barcelona Bellaterra Spain
| | - Xavier Roura
- Hospital Clínic Veterinari Universitat Autònoma de Barcelona Bellaterra Spain
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5
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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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6
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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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7
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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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8
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Johnson CM, Luke AS, Jacobsen C, Novak N, Dion GR. State of the Science in Tracheal Stents: A Scoping Review. Laryngoscope 2021; 132:2111-2123. [PMID: 34652817 DOI: 10.1002/lary.29904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 09/12/2021] [Accepted: 09/23/2021] [Indexed: 12/09/2022]
Abstract
OBJECTIVE Recent material science advancements are driving tracheal stent innovation. We sought to assess the state of the science regarding materials and preclinical/clinical outcomes for tracheal stents in adults with benign tracheal disease. METHODS A comprehensive literature search in April 2021 identified 556 articles related to tracheal stents. One-hundred and twenty-eight full-text articles were reviewed and 58 were included in the final analysis. Datapoints examined were stent materials, clinical applications and outcomes, and preclinical findings, including emerging technologies. RESULTS In the 58 included studies, stent materials were metals (n = 28), polymers (n = 19), coated stents (n = 19), and drug-eluting (n = 5). Metals included nitinol, steel, magnesium alloys, and elgiloy. Studies utilized 10 different polymers, the most popular included polydioxanone, poly-l-lactic acid, poly(d,l-lactide-co-glycolide), and polycaprolactone. Coated stents employed a metal or polymer framework and were coated with polyurethane, silicone, polytetrafluoroethylene, or polyester, with some polymer coatings designed specifically for drug elution. Drug-eluting stents utilized mitomycin C, arsenic trioxide, paclitaxel, rapamycin, and doxycycline. Of the 58 studies, 18 were human and 40 were animal studies (leporine = 21, canine = 9, swine = 4, rat = 3, ovine/feline/murine = 1). Noted complications included granulation tissue and/or stenosis, stent migration, death, infection, and fragmentation. CONCLUSION An increasing diversity of materials and coatings are employed for tracheal stents, growing more pronounced over the past decade. Though most studies are still preclinical, awareness of tracheal stent developments is important in contextualizing novel stent concepts and clinical trials. Laryngoscope, 2021.
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Affiliation(s)
- Christopher M Johnson
- Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center-San Diego, San Diego, California, U.S.A
| | - Alex S Luke
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas, U.S.A
| | | | - Nicholas Novak
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, U.S.A
| | - Gregory R Dion
- Department of Otolaryngology-Head and Neck Surgery, Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, Texas, U.S.A.,Dental and Craniofacial Trauma Research Department, U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, U.S.A
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9
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Serrano-Casorran C, Lopez-Minguez S, Rodriguez-Zapater S, Bonastre C, Guirola JA, De Gregorio MA. A new airway spiral stent designed to maintain airway architecture with an atraumatic removal after full epithelization-Research of feasibility and viability in canine patients with tracheomalacia. Pediatr Pulmonol 2020; 55:1757-1764. [PMID: 32407602 DOI: 10.1002/ppul.24816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/30/2020] [Accepted: 05/02/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Surgical management of tracheomalacia is a challenge, with current treatments still presenting numerous complications. In the field of veterinary medicine, this same pathology is present in a significant number of dogs. For this reason, we present an experimental clinical trial performed on canines with tracheobronchomalacia, using a new atraumatic removable tracheal spiral stent (SS). Both implantation procedure and clinical improvement have been analyzed in this study. METHODS In this study, four small dogs, a mean weight of 4.89 kg and body condition scores IV-V, were included. SS was implanted by two different surgical approaches. Image and clinical follow-up have been performed during 90 days. Symptoms were evaluated from 1 to 10 every week. RESULTS This study achieved 100% technical and clinical success. Median tracheal diameters were as follows: cervical 10.85 (3.3), inlet 7.75 (2.1), and carina 7.75 (1.9) mm, and length was 77.5 (26) mm. A 12 × 10 × 100-mm SS was implanted in all cases. Goose honk cough punctuation improved from 8 to 1; also, there were important changes in exercise intolerance, a mean weight loss of 8.76%. The values of modified Karnofsky scale varied from 50 (20) before surgery to 90 (10) after 30 days of surgery. Neither granuloma tissue nor fractures of the prosthesis was observed. CONCLUSION The results in dogs are promising, and a new therapeutic alternative seems to be available for veterinarian field. The similarity of this disease between dogs and newborns suggests that this SS design can also be useful for human trials.
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Affiliation(s)
- Carolina Serrano-Casorran
- Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain.,Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain.,Minimally Invasive Unit, Veterinary School of the University of Zaragoza, Spain
| | - Sandra Lopez-Minguez
- Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain.,Minimally Invasive Unit, Veterinary School of the University of Zaragoza, Spain
| | - Sergio Rodriguez-Zapater
- Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain.,Minimally Invasive Unit, Veterinary School of the University of Zaragoza, Spain
| | - Cristina Bonastre
- Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain.,Department of Animal Pathology, University of Zaragoza, Zaragoza, Spain.,Minimally Invasive Unit, Veterinary School of the University of Zaragoza, Spain
| | - Jose A Guirola
- Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain.,Interventional Radiology Department, Lozano Blesa University Hospital, Zaragoza, Spain
| | - Miguel A De Gregorio
- Minimally Invasive Techniques Research Group (GITMI), University of Zaragoza, Zaragoza, Spain.,Interventional Radiology Department, Lozano Blesa University Hospital, Zaragoza, Spain
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10
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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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11
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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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12
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Suematsu M, Suematsu H, Minamoto T, Machida N, Hirao D, Fujiki M. Long-term outcomes of 54 dogs with tracheal collapse treated with a continuous extraluminal tracheal prosthesis. Vet Surg 2019; 48:825-834. [PMID: 31115067 DOI: 10.1111/vsu.13229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 03/22/2019] [Accepted: 04/14/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To describe the surgical placement of a continuous extraluminal tracheal prosthesis (CETP) and report the subsequent postoperative clinical outcomes in dogs with tracheal collapse. STUDY DESIGN Retrospective case series. ANIMALS Fifty-four dogs. METHODS Medical records of dogs in which cervical and/or thoracic inlet tracheal collapse was diagnosed and treated by placement of a CETP between 2010 and 2017 were reviewed to evaluate postoperative complications, changes in respiratory function, and survival. Histological examinations of tracheal tissues performed in 2 dogs at 51 and 57 months after surgery were also reviewed. RESULTS Fifty-three (98%) dogs survived to discharge. Postoperative complications included laryngeal paralysis (1 dog), disseminated intravascular coagulation (1 dog), and recurrent tracheal collapse (2 dogs). None of the dogs exhibited clinical evidence of tracheal necrosis. Preoperative dry, harsh cough resolved in 87% of the dogs after surgery. Goose honking cough was resolved in 25 of 26 (96%) dogs. Median follow-up time was 30 months (range, 16 days to 76 months). The survival rate at 36 months was 86% (CI: 75%-96%). On histological examination in 2 dogs, the tracheal tissue surrounding the prosthesis was well preserved and without evidence of chronic inflammation. CONCLUSION Continuous extraluminal tracheal prosthesis placement in dogs with tracheal collapse resulted in low postoperative complication rates and good long-term outcomes. CLINICAL SIGNIFICANCE Continuous extraluminal tracheal prosthesis placement provides a viable alternative surgical option for managing dogs with tracheal collapse.
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Affiliation(s)
- Masahiro Suematsu
- AMC Suematsu Animal Hospital, Oita, Japan.,Laboratory of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima, Japan
| | | | | | - Noboru Machida
- Cooperative Department of Veterinary Medicine, Laboratory of Veterinary Clinical Oncology, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | | | - Makoto Fujiki
- Laboratory of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima, Japan
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13
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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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14
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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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15
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Focsaneanu V, Nelissen P, Tappin S. Surgical correction of severe dorsal tracheal membrane redundancy in a Belgian shepherd dog. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A two-year-old working Belgian shepherd dog was referred for diagnosis and management of a chronic cough, exercise intolerance and inspiratory stridor. A diagnosis of severe dorsal tracheal membrane redundancy was made based on radiography and tracheoscopy. Vomiting, weight loss and lethargy were also reported at initial presentation presumed secondary to dietary indiscretion, which was supported by the identification of undigested bones in the stomach on radiographs and ultrasound; these signs resolved with symptomatic treatment. The patient had previously been diagnosed with primary immune-mediated polyarthritis and had responded well to immunomodulatory medication. To correct the narrowing of the tracheal lumen, the dorsal tracheal membrane was plicated surgically, improving the tracheal diameter postoperatively. Twelve weeks later the dog had returned to full exercise, and the handler reported excellent exercise tolerance and no cough. Plication of excessive dorsal tracheal membrane is one possible treatment option for dogs with severe dorsal tracheal membrane redundancy.
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16
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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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