title: Clinical application of the Natural Y stent in the management of benign carinal stenosis.
abstract: BACKGROUND
  The Y-shaped structure of the carinal bifurcation causes difficulties in the treatment of carinal stenosis. We describe a new Y-shaped silicone stent, called the Natural Y stent. We investigated its clinical efficacy through a review of patients with benign carinal stenosis who undewent consecutive Natural Y stent placement.
  
  
  METHODS
  Between January 2004 and February 2008, 11 patients underwent ballooning, neodymium:yttrium-aluminum-garnet laser resection, or bougienation (by rigid bronchoscopy) to dilate the airway, followed by placement of the Natural Y stent.
  
  
  RESULTS
  The underlying etiologies of carinal stenosis included posttuberculosis stricture in 7 patients (64%), postintubation stenosis in 2 (18%), and postoperative malacia in 2 (18%). All patients reported subjective symptomatic relief immediately after stent placement. No procedurally related deaths or immediate major complications occurred. Stent-related late complications included granulation tissue formation (64%) and mucostasis (18%, defined as > or = 50% narrowing). The median duration of overall stent placement was 439 days (range, 119 to 1729 days). The stents were successfully removed in 4 patients (36%) after a median of 409 days.
  
  
  CONCLUSIONS
  The Natural Y stent provides an effective and feasible therapeutic modality in patients with benign carinal stenosis, with or without previous thoracic airway interventions.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hae-Seong
authors.initials: HS
authors.lastname: Nam
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Um
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
authors.forename: Man Pyo
authors.initials: MP
authors.lastname: Chung
authors.forename: O Jung
authors.initials: OJ
authors.lastname: Kwon
authors.forename: Jhingook
authors.initials: J
authors.lastname: Kim
authors.forename: Hojoong
authors.initials: H
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D013147:Spirometry; D015607:Stents / Q000009:adverse effects; D014397:Tuberculosis, Pulmonary / Q000150:complications