Radiology-guided forceps biopsy and airway stenting in severe airway stenosis

Diagn Interv Radiol. 2014 Jul-Aug;20(4):349-52. doi: 10.5152/dir.2014.12118.

Abstract

Purpose: We aimed to determine the feasibility, safety, and effectiveness of radiology-guided forceps biopsy and airway stenting in patients with severe airway stenosis.

Materials and methods: This study involved 28 patients with severe airway stenosis who underwent forceps biopsy between October 2006 and September 2011. Chest multislice computed tomography was used to determine the location and extent of stenosis. Sixteen patients had tracheal stenosis, two patients had stenosis of the tracheal carina, six patients had stenosis of the left main bronchus, and four patients had stenosis of the right main bronchus. Forceps biopsy and stenting of the stenosed area were performed under fluoroscopic guidance in digital subtraction angiography and the biopsy specimens were analyzed histopathologically. We contacted the patients via phone call and utilized a standardized questionnaire to determine their medical condition during a postoperative three-month follow-up.

Results: The technical success rate of radiology-guided forceps biopsy was 100%. Biopsy specimens were obtained in all patients. Dyspnea was relieved immediately after stent placement. No serious complications, such as tracheal hemorrhage or perforation, mediastinal emphysema, or asphyxia, occurred.

Conclusion: Radiology-guided forceps biopsy and airway stenting can be used for the emergency treatment of severe airway stenosis. This method appears to be safe and effective, and it may be an alternative therapeutic option in patients who cannot tolerate fiberoptic bronchoscopy.

MeSH terms

  • Adult
  • Aged
  • Airway Obstruction / diagnostic imaging
  • Airway Obstruction / pathology
  • Airway Obstruction / surgery
  • Angiography, Digital Subtraction
  • Bronchi / pathology
  • Bronchial Diseases / diagnostic imaging
  • Bronchial Diseases / pathology*
  • Bronchial Diseases / surgery*
  • Bronchography
  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / pathology
  • Constriction, Pathologic / surgery
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Image-Guided Biopsy / instrumentation
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Radiography, Interventional*
  • Stents*
  • Surgical Instruments
  • Surveys and Questionnaires
  • Trachea / diagnostic imaging
  • Trachea / pathology
  • Tracheal Stenosis / diagnostic imaging
  • Tracheal Stenosis / pathology*
  • Tracheal Stenosis / surgery*