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Benign tracheobronchial stenoses: long-term clinical experience with balloon dilation
Kwang-Hun Lee1, Gi-Young Ko, Ho-Young Song
1Departments of Diagnostic Radiology and Research, Institute of Radiological Science, Yonesei University College of Medicine,Yong Dong Severance Hospital, Seoul, South Korea.
Purpose:
To assess the safety and long-term efficacy of balloon dilation in the treatment of benign tracheobronchial stenosis.
Materials And Methods:
Balloon dilation was performed under fluoroscopic guidance in 59 consecutive patients with benign tracheobronchial stenosis. Most patients had tuberculosis (48 of 59, 81%). Two to three serial balloon insufflations were performed for 5-180 seconds (mean, 85 sec) with inflation pressures as high as 16 atm with use of 6-20-mm-diameter balloon catheters. Patients with clinical evidence of restenosis underwent repeat balloon dilation. Patients were followed for 12-42 months (mean, 32 mo).
Results:
A total of 101 balloon dilation sessions were performed in 59 patients, with a range of one to four sessions per patient (mean, 1.7 sessions). Initial symptomatic improvement was achieved in 49 (83%) of the 59 patients; however, during the follow-up period, 39 (80%) of the 49 patients experienced recurrence of their symptoms. The primary patency rates at 3, 6, 9, 12, 18, 24, and 32 months were 92%, 60%, 45%, 24%, 20%, 20%, and 20%, respectively. The secondary patency rates at 3, 6, 9, 12, 18, 24, and 32 months were 92%, 87%, 75%, 43%, 43%, 43%, and 43%, respectively. Procedure-related major complications of deep mucosal laceration (n = 2) and bronchospasm (n = 1) occurred in three patients, but they experienced no subsequent problems.
Conclusion:
Although the recurrence rate is high during the long-term follow-up period, balloon dilation seems to be a safe primary treatment modality for benign tracheobronchial stenoses and has an acceptable secondary patency rate.