title: Covered expandable tracheal stents in the management of benign tracheal granulation tissue formation.
abstract: BACKGROUND
  Tracheal obstruction secondary to benign proliferation of granulation tissue is a difficult problem to address if tracheal resection is contraindicated. Some patients may benefit from Nd:YAG (neodymium: yttritium-aluminum garnet) laser fulguration or tracheal stenting. If uncovered expandable metallic stents are employed granulation tissue can regrow and proliferate through the mesh, thereby obstructing the lumen once again. Covered metallic stents confer the advantage of preventing granulation tissue proliferation and therefore maintain patency of the tracheal lumen.
  
  
  METHODS
  Two patients who developed tracheal obstruction secondary to proliferating granulation tissue formation after tracheostomy and who were medically unfit for prolonged general anesthesia were successfully treated using covered expandable metallic tracheal stents.
  
  
  RESULTS
  Each patient demonstrated a significant improvement in respiratory status, and in both patients, at 6 and 9 months' follow-up, stent position has not changed, tracheal lumen remains patent, and there has been no proliferation of granulation tissue through the stent.
  
  
  CONCLUSIONS
  Covered expandable metallic stents should be considered in the management of patients with proliferating tracheal granulation tissue when tracheal resection is contraindicated.
authors.affiliation: Department of Cardiothoracic Surgery, St George's Hospital, Tooting, London, England.
authors.forename: B P
authors.initials: BP
authors.lastname: Madden
authors.forename: S A
authors.initials: SA
authors.lastname: Stamenkovic
authors.forename: P
authors.initials: P
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D020099:Coated Materials, Biocompatible; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006097:Granulation Tissue / Q000473:pathology / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy; D008875:Middle Aged; D015607:Stents; D014135:Tracheal Stenosis / Q000473:pathology / Q000601:surgery*; D014139:Tracheostomy
chemical_list: D020099:Coated Materials, Biocompatible