title: Clinical experience with a new removable tracheobronchial stent in the management of airway complications after lung transplantation.
abstract: BACKGROUND
  Airway complications are among the most challenging problems after lung transplantation. This article describes the use of a new tracheobronchial stent that can be placed and removed easily by flexible bronchoscopy.
  
  
  METHODS
  A retrospective review was done of 24 consecutive patients requiring tracheobronchial stent placement after lung transplantation. A new self-expanding hybrid nitinol stent was used, and changes in airway diameter and spirometry were assessed. Stent related complications were recorded.
  
  
  RESULTS
  Between February 2007 and April 2008, 24 patients underwent stent placement, and 49 stents were placed for 36 anastomoses at risk. Indications included bronchial stenosis in 12, bronchomalacia in 12, bronchial stenosis plus bronchomalacia in 20, and partial bronchial dehiscence in 5. Adjunctive procedures included electrocautery in 1, balloon dilatation in 7, and electrocautery plus balloon dilatation in 4. The average degree of stenosis decreased from 80% to 20%. After stent placement, the average increase was 0.28 liters in forced vital capacity and 0.44 liters in forced expiratory volume in 1 second. Complications included granulation tissue formation in 10 stents, migration in 9, thick mucus formation in 2, and fracture in 3.
  
  
  CONCLUSIONS
  Airway complications in lung transplant patients were effectively palliated. Our complication rate with this new stent is comparable with other airway stents. This stent has the advantage of easy removability during flexible bronchoscopy if complications from the stent outweigh the benefits of palliation.
authors: Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida Health Science Center, Gainesville, FL 32610, USA. bussysf@medicine.ufl.edu
authors: Sebastian
authors: S
authors: Fernandez-Bussy
authors: Olufemi
authors: O
authors: Akindipe
authors: Varsha
authors: V
authors: Kulkarni
authors: Wendy
authors: W
authors: Swafford
authors: Maher
authors: M
authors: Baz
authors: Michael A
authors: MA
authors: Jantz
mesh_terms: D000328:Adult; D000368:Aged; D000497:Alloys; D001980:Bronchi / Q000503:physiopathology*; D055091:Bronchomalacia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D001999:Bronchoscopy; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011666:Pulmonary Valve Stenosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents; D014132:Trachea / Q000503:physiopathology*; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology
chemical_list: D000497:Alloys; C013616:nitinol