Objective To evaluate the application value of spiral CT virtual endoscopy and three dimensional imaging in fiberoptic bronchoscopic balloon dilation in patients with benign tracheobronchial stenosis. Methods Thirty-three cases of benign tracheobronchial stenosis from June 2004 to November 2008 were checked by spiral CT with airway tracheobronchial reconstruction. For the patients with indications, balloon dilatation was performed under fiberoptic bronchoscope. The three-dimensional reconstruction images were compared with the findings under bronchoscopy. And the preoperative and postoperative three-dimensional reconstruction images were compared for airway diameter. Results Three cases were found stenosis of middle lobe by CT virtual endoscopy and did not undergo balloon dilatation. The remaining 30 cases were confirmed by bronchoscopy findings similar to the images by tracheobronchial reconstruction with CT, with consistent rate of 100% . Immediate postoperative three-dimensional CTreconstruction of tracheal bronchus revealed that diameter of stenotic bronchus increased from ( 2. 7 ±1. 3) mm to ( 6. 9 ±1. 6) mmafter operation. Conclusion Multislice spiral CT virtual endoscopy is helpful in fiberoptic bronchoscopic balloon dilation in patients with benign tracheobronchial stenosis and postoperative follow-up.
Objective To investigate the feasibility and therapeutic efficacy of inverted Y-shaped self-expandable metal airway stent for complex airway diseases ( stenosis or fistula) .Methods According to the particular anatomic structure and the pathological changes of complex airway diseases, the inverted Y-shaped self-expandable metal airway stent was designed. 10 stents were implanted in 10 cases of airway complex diseases under the guidance of interventional fibroscopy and fluoroscopy. Results The inverted Y-shaped stents were placed successfully with immediate relief of the symptoms. 100% of the patients were able to be weaned fromoxygen therapy completely. Dyspnea grade improved significantly fromⅢ-Ⅳ to 0-Ⅱ,and oxygen saturation elevated from ( 85 ±5) % in inspiring high concentration oxygen to ( 95 ±3) % in breathing ambient air ( t = - 7. 352, P lt;0. 05) . Breathlessness in 2 cases with tracheoesophageal fistula was relieved after inserting covered airway stent without bucking while foodintaking after fasting 24 hours.Conclusion The placement of inverted Y-shaped self-expandable metal airway stent is a feasible and safetreatment for complex airway disease such as stenosis or fistula.
Objective To summarize the diagnosis and treatment of spontaneous rupture of bronchial artery aneurysm in mediastinum.Methods Two cases diagnosed as bronchial artery aneurysmby methods of enhanced-CT plus independent post-procedure techniques and bronchial artery selective angiography were cured by different intervention surgeries in our hospital. The clinical data of these two patients and different interventional treatments were summarized.Results Case 1 was a 38-year old male.He was given coils and PVC micro-particles, and bronchial artery selective angiography showed distal vascular occlusion and aneurysmsize decreased. Case 2 was a 59-year old female. She was also given coils, but digital subtraction angiography showed bleeding of bronchial artery whose opening was near to the aorta.Then a stent was implanted in the descending aorta to isolate the bleeding bronchial artery, and bronchial artery selective angiography showed blood flow was completely blocked. Conclusions Enhanced-CT plus vascular three-dimensional reconstruction and bronchial artery selective angiography is a chief method to diagnose bronchial artery aneurysm. Bronchial artery embolization and/ or isolating surgery with covered stent are minimally invasive, efficient, trustworthy treatment for spontaneous rupture of bronchial-artery aneurysmin mediastinum. Different techniques of interventional treatment are selected depending on lesion.