title: Factors leading to tracheobronchial self-expandable metallic stent fracture.
abstract: OBJECTIVE
  This retrospective study was to determine factors that contribute to self-expandable metallic stent fracture in patients with tracheobronchial disease.
  
  
  METHODS
  From 2001 to 2006, 139 patients (age, 62.1 +/- 15.4 years; range, 23-87 years) with benign (n = 62) and malignant (n = 77) tracheobronchial disease received 192 Ultraflex (Boston Scientific, Natick, Mass) self-expandable metallic stents (98 in patients with benign disease and 94 in patients with malignant disease).
  
  
  RESULTS
  Seventeen fractured self-expandable metallic stents were found; the incidence was 12.2% (17/139 patients) among patients with tracheobronchial disease. Tortuous airway (odds ratio, 4.06; 95% confidence interval, 1.04-18.34; P = .04) independently predicted self-expandable metallic stent fracture. Most self-expandable metallic stent fractures (64.7%, 11/17) were detected 500 to 1000 days after self-expandable metallic stent implantation. Clinical presentations for patients with fractured self-expandable metallic stents included dyspnea exacerbation (70.6%, 12/17) and cough (23.5%, 4/17).
  
  
  CONCLUSIONS
  Self-expandable metallic stent fracture is not uncommon in patients with tracheobronchial disease. Tortuous airway is an independent predictor for it. Although management of the fractured self-expandable metallic stent in our study was feasible and safe, self-expandable metallic stents should be restricted to a more select population.
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan.
authors.forename: Fu-Tsai
authors.initials: FT
authors.lastname: Chung
authors.forename: Shu-Min
authors.initials: SM
authors.lastname: Lin
authors.forename: Hao-Cheng
authors.initials: HC
authors.lastname: Chen
authors.forename: Chun-Liang
authors.initials: CL
authors.lastname: Chou
authors.forename: Chih-Teng
authors.initials: CT
authors.lastname: Yu
authors.forename: Chien-Ying
authors.initials: CY
authors.lastname: Liu
authors.forename: Chun-Hua
authors.initials: CH
authors.lastname: Wang
authors.forename: Horng-Chyuan
authors.initials: HC
authors.lastname: Lin
authors.forename: Chien-Da
authors.initials: CD
authors.lastname: Huang
authors.forename: Han-Pin
authors.initials: HP
authors.lastname: Kuo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001982:Bronchial Diseases / Q000628:therapy*; D001984:Bronchial Neoplasms / Q000628:therapy; D001999:Bronchoscopy; D004868:Equipment Failure; D006801:Humans; D008670:Metals; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D014133:Tracheal Diseases / Q000628:therapy*; D014134:Tracheal Neoplasms / Q000628:therapy; D055815:Young Adult
chemical_list: D008670:Metals