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Ding XM, Ding YA, Duan YF, Chen JY, Li L, Ren FP, Sun J. A novel method for precise implantation of tracheal Y-shaped stent. Front Med (Lausanne) 2024; 11:1337669. [PMID: 38651056 PMCID: PMC11033420 DOI: 10.3389/fmed.2024.1337669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
The tracheal Y-shaped stent is mainly used for the treatment of critical patients with airway stenosis or esophagotracheal fistula near carina. A novel method for precise implantation of Y-shaped tracheal stents was developed using double-lumen endotracheal intubation and flexible bronchoscopy. This approach aims to address the limitations associated with X-ray or rigid bronchoscopy guidance, such as operational difficulties and the risk of inaccurate stent placement leading to implantation failure or suffocation. With this new technique, 13 tracheal Y-shaped stents were successfully implanted. This method shows promise in reducing the complexity of stent implantation and facilitating timely treatment for patients in need. Additionally, it has the potential to update current operating standards and guidelines for this procedure.
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Affiliation(s)
- Xin-Min Ding
- Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
| | | | - Yan-Fang Duan
- Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
| | - Jiao-Yang Chen
- Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
| | - Long Li
- Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
| | - Fang-Ping Ren
- Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
| | - Jie Sun
- Department of Respiratory and Critical Care Medicine, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China
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Han J, Yan X, Cui H, Zhang H, Lu B, Xu J. Robot-Assisted Correction of a Supra-Long Tracheal Stenosis Using C-Type Nickel-Titanium Alloy Exterior Stenting and Suspension Fixation Technique: A Case Report. Ann Thorac Cardiovasc Surg 2024; 30:24-00012. [PMID: 38839349 PMCID: PMC11196161 DOI: 10.5761/atcs.cr.24-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/25/2024] [Indexed: 06/07/2024] Open
Abstract
T-tubes and airway stents are commonly used but have limited effectiveness and frequent complications. A 50-year-old male patient presented with severe tracheal stenosis, affecting an 8.7 cm length of the airway. We employed an innovative approach known as external suspension fixation of tracheal stent using robotic assistance. This method involves surgically attaching the stent to the exterior of the trachea to provide support and stabilize the softened or collapsed tracheal segments. We designed a C-shaped nickel-titanium alloy exterior stent and successfully fixed it using robotic assistance. This intervention effectively restored tracheal function and led to a favorable postoperative recovery. The technique does not affect tracheal membrane function or airway mucociliary clearance. It could potentially be considered as a new option for treating long-segment benign tracheal softening or collapse.
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Affiliation(s)
- Jingquan Han
- Department of Thoracic Surgery, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xi Yan
- Department of Thoracic Surgery, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hongwei Cui
- The Eighth Ward of Tuberculosis, Harbin Chest Hospital, Harbin, China
| | - Hang Zhang
- Department of Thoracic Surgery, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Bei Lu
- Department of Thoracic Surgery, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jinzhi Xu
- Department of Thoracic Surgery, the Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
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Gupta A, Burgess JK, Borghuis T, de Vries MP, Kuipers J, Permentier HP, Bischoff R, Slebos DJ, Pouwels SD. Identification of damage associated molecular patterns and extracellular matrix proteins as major constituents of the surface proteome of lung implantable silicone/nitinol devices. Acta Biomater 2022; 141:209-218. [PMID: 35038586 DOI: 10.1016/j.actbio.2022.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/23/2021] [Accepted: 01/07/2022] [Indexed: 11/15/2022]
Abstract
Lung implantable devices have been widely adopted as mechanical interventions for a wide variety of pulmonary pathologies. Despite successful initial treatment, long-term efficacy can often be impacted by fibrotic or granulation tissue formation at the implant sites. This study aimed to explore the lung-device interface by identifying the adhered proteome on lung devices explanted from patients with severe emphysema. In this study, scanning electron microscopy is used to visualize the adhesion of cells and proteins to silicone and nitinol surfaces of explanted endobronchial valves. By applying high-resolution mass-spectrometry, the surface proteome of eight explanted valves is characterized, identifying 263 unique protein species to be mutually adsorbed on the valves. This subset is subjected to gene enrichment analysis, matched with known databases and further validated using immunohistochemistry. Enrichment analyses reveal dominant clusters of functionally-related ontology terms associated with coagulation, pattern recognition receptor signaling, immune responses, cytoskeleton organization, cell adhesion and migration. Matching results show that extracellular matrix proteins and damage-associated molecular patterns are cardinal in the formation of the surface proteome. This is the first study investigating the composition of the adhered proteome on explanted lung devices, setting the groundwork for hypothesis generation and further exploration. STATEMENT OF SIGNIFICANCE: This is the first study investigating the composition of the adhered proteome on explanted lung devices. Lung implantable devices have been widely adopted as mechanical interventions for pulmonary pathologies. Despite successful initial treatment, long-term efficacy can often be impacted by fibrotic or granulation tissue formation around the implant sites. We identified the adhered proteome on explanted lung devices using several techniques. We identified 263 unique protein species to be mutually adsorbed on explanted lung devices. Pathway analyses revealed that these proteins are associated with coagulation, pattern recognition receptor signaling, immune responses, cytoskeleton organization, cell adhesion and migration. Furthermore, we identified that especially extracellular matrix proteins and damage-associated molecular patterns were cardinal in the formation of the surface proteome.
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Affiliation(s)
- Akash Gupta
- University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pathology & Medical Biology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Janette K Burgess
- University of Groningen, University Medical Center Groningen, Department of Pathology & Medical Biology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Theo Borghuis
- University of Groningen, University Medical Center Groningen, Department of Pathology & Medical Biology, Groningen, the Netherlands
| | - Marcel P de Vries
- Department of Analytical Biochemistry and Interfaculty Mass Spectrometry Center, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Jeroen Kuipers
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Hjalmar P Permentier
- Department of Analytical Biochemistry and Interfaculty Mass Spectrometry Center, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Rainer Bischoff
- Department of Analytical Biochemistry and Interfaculty Mass Spectrometry Center, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Dirk-Jan Slebos
- University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands
| | - Simon D Pouwels
- University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Pathology & Medical Biology, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, the Netherlands.
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