Placement of covered retrievable expandable metallic stents for pediatric tracheobronchial obstruction.
OBJECTIVE
To evaluate the safety and clinical effectiveness of placement of covered retrievable expandable metallic stents in seven children with tracheobronchial obstruction.


METHODS
Using bronchoscopic and fluoroscopic guidance, stent placement was performed in seven children (median age, 12 y; range, 2 mo-14 y). The stents were electively removed 6 months after placement or whenever there were symptom-producing complications. During the follow-up period, technical and clinical success, complications and related reinterventions, and long-term prognosis were retrospectively evaluated.


RESULTS
Stent placement was technically successful for a total of eight stents in all seven patients. Stent removal was also successful for six stents in five patients; two stents were removed electively 6 months after placement, and four stents were removed due to symptom-producing complications. Clinical success defined as ventilator weaning, extubation, or dyspnea improvement was achieved in all patients 1 week after stent placement. A possible infection source in one stent and abundant granulation tissue caused by three stents necessitated removal of four stents in three patients. During the mean follow-up period of 18.7 months (range, 1-31 mo) after stent placement, three patients died due to the progression of underlying cardiopulmonary disease or malignancy. There were no deaths directly related to stent placement or related complications.


CONCLUSIONS
Although the findings were based on a small series, placement of covered retrievable expandable metallic stents seems to be safe and effective for the treatment of pediatric tracheobronchial obstruction. Ventilator weaning, extubation, or dyspnea improvement was possible in all patients after stent placement.
Shin
Ji Hoon
JH
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Poongnap-2dong, Songpa-gu, Seoul 138-736, Korea. sjhong@amc.seoul.kr
Hong
Soo-Jong
SJ
Song
Ho-Young
HY
Park
Seong Jong
SJ
Ko
Gi-Young
GY
Lee
So-Yeon
SY
Kim
Hyo-Bin
HB
Jang
Joo-Young
JY
D000293:Adolescent; D000497:Alloys; D001982:Bronchial Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D001999:Bronchoscopy; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D003251:Constriction, Pathologic; D020878:Device Removal; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D008297:Male; D011379:Prognosis; D015641:Radiography, Interventional; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D014135:Tracheal Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
D000497:Alloys; C013616:nitinol