Factors leading to tracheobronchial self-expandable metallic stent fracture.
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.
Chung
Fu-Tsai
FT
Department of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taipei, Taiwan.
Lin
Shu-Min
SM
Chen
Hao-Cheng
HC
Chou
Chun-Liang
CL
Yu
Chih-Teng
CT
Liu
Chien-Ying
CY
Wang
Chun-Hua
CH
Lin
Horng-Chyuan
HC
Huang
Chien-Da
CD
Kuo
Han-Pin
HP
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
D008670:Metals