Percutaneous vascular stent implantation as treatment for central XXXX due to fibrosing mediastinitis.

@entity1 @entity455 @entity17791 @entity3218 @entity204
BACKGROUND: @entity17791 ( @entity17791 ) is a rare complication of infection with @entity3218 that can lead to obstruction of pulmonary and systemic vasculature and large airways, often resulting in significant morbidity and mortality. Medical therapy is ineffective, and surgical intervention is often not feasible. Stent implantation offers a potential treatment for @entity455 due to @entity17791 , but this has not been well studied. METHODS AND RESULTS: We conducted a retrospective review of all @entity1 undergoing cardiac catheterization for @entity17791 . Anatomic site of stenosis and hemodynamic information before and after intervention, as well as clinical presentation and follow-up data, were recorded. From 1996 to 2008, 58 @entity1 underwent cardiac catheterization for @entity17791 , with intervention performed in 40 (69%). A total of 77 stents were used to relieve 59 lesions (pulmonary artery=26, pulmonary vein=21, and superior vena cava=12). Significant reduction in pressure gradients (P<0.001) and increase in vessel caliber (P<0.001) were seen at all locations. Symptomatic recurrent stenosis requiring further intervention occurred in 11 @entity1 (28%). Median time to recurrence was 115 months. Thirty-two (87%) of 37 @entity1 for whom follow-up was available reported symptomatic improvement after stent placement. PROCEDURE: related complications occurred in 14 @entity1 (24%). Overall mortality was 19%, with the majority of @entity204 in @entity1 with bilateral disease. Among @entity1 with bilateral disease, intervention was associated with improved survival at 5 years. CONCLUSION: Percutaneous vascular stent implantation is an effective therapy for central @entity455 due to @entity17791 , providing significant relief of anatomic obstruction and sustained clinical improvement.
