title: Secondary carina Y-stent placement for post-lung-transplant bronchial stenosis.
abstract: BACKGROUND
  Post-lung-transplant bronchial stenosis (TBS) may cause significant morbidity and mortality. Although often transiently relieved by balloon bronchoplasty, stents may be required for long-term airway patency. We report a series of lung transplant patients in whom a silicone Y-stent was placed at the secondary carina for long-standing relief of post-transplant-airway stenosis.
  
  
  METHODS
  Six lung transplant patients received 10 silicone Y-stents in the secondary carina over the past 18 months for post-transplant-bronchial stenosis. All patients failed other interventional therapeutic procedures including balloon bronchoplasty and/or conventional stenting before secondary carina Y-stent placement. Patient data include 12 months' follow-up after Y-stent insertion. The number of procedures and the interval between procedures was examined before and after secondary carina silicone Y-stent placement.
  
  
  RESULTS
  There was a significantly prolonged therapeutic effect accomplished in these patients after secondary carina Y-stent placement with the exception of 1 patient. When stents were tolerated by the patient, the mean number of procedures before secondary carina Y-stent insertion was 15.6, but only 4.8 after Y-stent insertion. The number of days between procedures was 24.5 days before the Y-stent insertion and 85.8 days after the Y-stent insertion. There were no complications in any patient during secondary carina Y-stent insertion.
  
  
  CONCLUSIONS
  Secondary carina silicone Y-stent placement in TBS decreased the number of therapeutic procedures and provided longer-lasting results in most posttransplant patients who required multiple prior procedures for TBS.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Virginia Commonwealth University Medical Center, Richmond, VA, USA.
authors.forename: Hans Joo
authors.initials: HJ
authors.lastname: Lee
authors.forename: Jonathan
authors.initials: J
authors.lastname: Puchalski
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Sterman
authors.forename: Krish
authors.initials: K
authors.lastname: Bhadra
authors.forename: Rohit
authors.initials: R
authors.lastname: Kumar
authors.forename: Colin T
authors.initials: CT
authors.lastname: Gillespie
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Haas
mesh_terms: D001982:Bronchial Diseases / Q000601:surgery*; D001999:Bronchoscopy / Q000379:methods; D003251:Constriction, Pathologic / Q000601:surgery; D020878:Device Removal; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000601:surgery; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome