Endobronchial stent placement for the management of airway complications after lung transplantation.
OBJECTIVE
To retrospectively evaluate the efficacy and complications of endobronchial stent placement for the management of airway complications following lung transplant.


METHODS
From 1992 to 2003, tracheobronchial stenting was performed on 25 lung transplant recipients (16 male and 9 female; mean age 51.6 years; range 21-65 years). A total of 27 lesions were treated and 27 stents were deployed (nine bronchomalacia, 12 bronchial stenosis, three bronchial stenosis and bronchomalacia both and three anastomotic dehiscence). The clinical and bronchoscopic follow-up ranged from 1 month to 69 months.


RESULTS
The technical success was 100%. Eighty-four percent of patients had immediate relief in dyspnea. The overall complication rate following stent placement was 0.049 per patient per month (23 complications/471 patient months). Stent migration and granulation tissue formation were the most frequent complications. The mean percentage change in FEV-1 was significantly greater than zero at 1 month and 6 months (P<.05) post-stent placement. The mean percentage change in FEV-1 was marginally greater than zero at 12 months (P=.07).The mean percentage change in FVC was marginally greater than zero at 1 month and 6 months (P=.08) post-stent. It was not significantly greater than zero at 12 months (P=1.00).


CONCLUSIONS
Tracheobronchial stent placement provides effective palliation of postoperative airway complications in lung transplant with morbidity that can be managed effectively by available treatment options. Airway stenting may be used as a primary management option for airway complications after lung transplantation as a large number of patients are not suitable candidates for repeat surgery.
Kapoor
Baljendra S
BS
Vascular & Interventional Radiology, University of Alabama at Birmingham, H623 New Hillman Building, 619 19th Street S, Birmingham, AL 35249, USA, and Royal University Hospital Saskatoon, SK, Canada. bkapoor@uabmc.edu
May
Ben
B
Panu
Neety
N
Kowalik
Karen
K
Hunter
David W
DW
D000328:Adult; D000368:Aged; D001982:Bronchial Diseases / Q000209:etiology / Q000628:therapy*; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D001239:Inhalation; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000009:adverse effects; D012189:Retrospective Studies; D015607:Stents; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome