一种介入工具的历史和未来.ppt

* * Silicone Stents Dumon in Marseille proposed an original tracheobronchial silicone stent in 1987 (the Dumon-stent?). * tubular stents The tracheal stents are generally 50 to 60 mm long (maximum 110 mm), and 14 to 16 mm in diameter (maximum 18 mm). Bronchial stents are manufactured with diameters ranging from 10 to 12 mm and lengths between 20 to 40 mm. * Y stents Y stents designed to treat tumors extending to the carina. The lengths reaching up to 110 mm for the trachea, and 50 mm for the main stem bronchi. The right main stem limb may be fenestrated.  * Indications The principal indication for airway stenting is extrinsic compression of the airway. other indications : bronchial fistula, tracheobronchomalacia… * Y stent placement is reserved for tumors extending to the carina.  * Choice of the diameter and the lenght The diameter of the stent will depend on the external diameter of the bronchoscope used (yellow tube 16/15, red tube 14/13/12), while the length is measured by retracting the bronchoscope or telescope along the entire length of the stenosis.  * Placement Placement is performed using a tracheal or bronchial rigid tube. The stent is lubricated with silicone and loaded into a stent applicator. The applicator is the inserted through the bronchoscope and the stent is pushed out into the trachea or the bronchus. * Efer-Dumon applicator Two kind of loaders: tracheal or bronchial stent, Y stent or long and large straight stent. On the right two size of applicators. * Adjusting the stent is made by grasping the upper rim of the prosthesis with forceps. * * Stent related complications Stent obstruction Migration Granulomatous inflammation * Silicone coated stents are also available, either reinforced by a metallic (dynamic stent de Freitag?) or synthetic (Polyflex?) frame. * 气管/支气管支架 Case 4 * 气管插管 OR 喉罩? 硬质气管镜 * * 综合治疗 * * 总 结 Interventional PulmonologyNot your grandfather’s pulmonary medicine! RB仍是肺脏介入病学专业基础 支气管镜介入治疗大有发展前景