Clinical application of the Natural Y stent in the management of benign carinal stenosis.
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.
Nam
Hae-Seong
HS
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Um
Sang Won
SW
Koh
Won-Jung
WJ
Suh
Gee Young
GY
Chung
Man Pyo
MP
Kwon
O Jung
OJ
Kim
Jhingook
J
Kim
Hojoong
H
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