Abstract：
BACKGROUND: Airway stenting may be needed to manage anastomotic complications in lung transplant recipients. Conventional stenting strategies may be inadequate due to anatomic variations between the recipient and donor or involvement of both the anastomosis and lobar bronchi.
METHODS: We investigated the efficacy of 3D-designed patient-specific silicone Y-stents in managing this scenario. 9 patients with complex airway stenosis underwent custom stent insertion after either failing traditional management strategies or having anatomy not suitable for conventional stents. CT images were uploaded to stent design software to make a virtual stent model. 3D printing technology was then used to make a mold for the final silicone stent which was implanted via rigid bronchoscopy. Forced expiratory volume in 1 s (FEV1) was measured pre- and post-stent placement.
RESULTS: 78 % of patients experienced an increase in their FEV1 after stent insertion, (p = 0.001, 0.02 at 30 and 90 days respectively). Unplanned bronchoscopies primarily occurred due to mucous plugging. 2 patients had sufficient airway remodeling allowing for stent removal.
CONCLUSIONS: Personalized 3D-designed Y-stents demonstrate promising results for managing complicated airway stenosis, offering improved lung function and potential long-term benefits for lung transplant recipients.
METHODS: We investigated the efficacy of 3D-designed patient-specific silicone Y-stents in managing this scenario. 9 patients with complex airway stenosis underwent custom stent insertion after either failing traditional management strategies or having anatomy not suitable for conventional stents. CT images were uploaded to stent design software to make a virtual stent model. 3D printing technology was then used to make a mold for the final silicone stent which was implanted via rigid bronchoscopy. Forced expiratory volume in 1 s (FEV1) was measured pre- and post-stent placement.
RESULTS: 78 % of patients experienced an increase in their FEV1 after stent insertion, (p = 0.001, 0.02 at 30 and 90 days respectively). Unplanned bronchoscopies primarily occurred due to mucous plugging. 2 patients had sufficient airway remodeling allowing for stent removal.
CONCLUSIONS: Personalized 3D-designed Y-stents demonstrate promising results for managing complicated airway stenosis, offering improved lung function and potential long-term benefits for lung transplant recipients.
摘要：
背景：肺移植受者可能需要气道支架置入术来处理吻合口并发症。由于接受者和供体之间的解剖差异或吻合和大叶支气管的参与，常规的支架置入策略可能不足。
方法：我们研究了3D设计的患者专用硅胶Y型支架在处理这种情况中的功效。9例复杂气道狭窄患者在传统管理策略失败或解剖结构不适合常规支架后接受了定制支架插入。将CT图像上传到支架设计软件以制作虚拟支架模型。然后使用3D打印技术为最终的硅胶支架制造模具，该支架通过刚性支气管镜植入。在支架置入前后测量一秒内的用力呼气量(FEV1)。
结果：78％的患者在插入支架后FEV1增加，(分别在30天和90天时p=0.001,0.02)。非计划的支气管镜检查主要是由于粘液堵塞。2名患者有足够的气道重塑，允许移除支架。
结论：个性化3D设计的Y型支架在处理复杂的气道狭窄方面显示出良好的结果，为肺移植受者提供改善的肺功能和潜在的长期益处。
方法：我们研究了3D设计的患者专用硅胶Y型支架在处理这种情况中的功效。9例复杂气道狭窄患者在传统管理策略失败或解剖结构不适合常规支架后接受了定制支架插入。将CT图像上传到支架设计软件以制作虚拟支架模型。然后使用3D打印技术为最终的硅胶支架制造模具，该支架通过刚性支气管镜植入。在支架置入前后测量一秒内的用力呼气量(FEV1)。
结果：78％的患者在插入支架后FEV1增加，(分别在30天和90天时p=0.001,0.02)。非计划的支气管镜检查主要是由于粘液堵塞。2名患者有足够的气道重塑，允许移除支架。
结论：个性化3D设计的Y型支架在处理复杂的气道狭窄方面显示出良好的结果，为肺移植受者提供改善的肺功能和潜在的长期益处。
