title: Rigid bronchoscopic management of complications related to endobronchial stents after lung transplantation.
abstract: OBJECTIVE
  We reviewed the utility of rigid bronchoscopy in the management of complications resulting from placement of metallic endobronchial stents after lung transplantation.
  
  
  METHODS
  A retrospective review was performed of all lung transplant patients who required metallic endobronchial stenting between 2005 and 2009. The patients' medical records were reviewed, and details regarding stent placement, complications, and removal were recorded.
  
  
  RESULTS
  A total of 43 metallic stents were placed in 22 patients who had unilateral or bilateral lung transplantation. Stent complications occurred in 18 cases (42%) at a mean of 285 days after placement and included stent collapse, stent breakdown, stent migration, ingrowth of granulation tissue, and coughing up of fractured pieces of stent. Of the 43 stents placed, only 4 (9%) had to be removed. Removal was readily accomplished by rigid bronchoscopic techniques, even when some endothelial ingrowth had occurred.
  
  
  CONCLUSIONS
  Lung transplantation presents unique challenges in airway management. Endobronchial stenting plays an important role in the management of anastomotic stenosis and bronchomalacia in these patients. Although metallic stents have significant advantages, complications often arise that occasionally necessitate their removal. Rigid bronchoscopy is a valuable tool in the management of endobronchial stent complications after lung transplantation.
authors.affiliation: Department of Diagnostic Imaging, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
authors.forename: Jonas
authors.initials: J
authors.lastname: Redmond
authors.forename: Jay
authors.initials: J
authors.lastname: Diamond
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dunn
authors.forename: Gary S
authors.initials: GS
authors.lastname: Cohen
authors.forename: Ahmed M S
authors.initials: AM
authors.lastname: Soliman
mesh_terms: D000328:Adult; D000368:Aged; D001980:Bronchi; D055091:Bronchomalacia / Q000517:prevention & control; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000379:methods*; D003251:Constriction, Pathologic / Q000517:prevention & control; D005260:Female; D006097:Granulation Tissue / Q000601:surgery; D006801:Humans; D016040:Lung Transplantation / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D011475:Prosthesis Failure; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*