title: A Multicenter Experience With the Placement of Self-Expanding Metallic Tracheobronchial Y Stents.
abstract: BACKGROUND
  Deployment of a bifurcation (Y) stent is often required in patients with airway obstruction or fistulization near the tracheal carina. Herein, we describe our experience with placement of self-expanding metallic Y stents.
  
  
  METHODS
  This was a retrospective analysis of data of consecutive subjects who underwent placement of self-expanding metallic Y stent over 2 years at 6 different centers. We describe the technique, complications, and outcomes of metallic Y stent placement at the tracheal carina.
  
  
  RESULTS
  Thirty-eight subjects (25 men) with a mean age of 54.8 years underwent Y stent placement. The most common underlying disease was carcinoma of the esophagus (65.8%). The most common indication for stent insertion was central airway obstruction in 30 (78.9%) subjects followed by airway-esophageal fistula. Respiratory failure was present in 17 (44.7%) subjects at admission. The Y stent was deployed using either the rigid (n=32) or the flexible (n=6) bronchoscope, and was successfully placed in 37 of the 38 (97.4%) subjects. There was rapid improvement in symptoms and subsequent resolution of respiratory failure after stent placement. There was no periprocedural mortality and few stent-related complications. On follow-up at 12 weeks, 18 patients had died due to progression of the underlying disease.
  
  
  CONCLUSIONS
  The insertion of a metallic Y stent results in immediate palliation of malignant airway obstruction or airway fistulization near the tracheal carina with rapid improvement of symptoms.
authors.affiliation: *Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi ∥Pulmonary Services, Jaipur Golden Hospital, Rajiv Gandhi Cancer Institute, New Delhi †Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh ‡Pulmonary Services, Apollo Hospitals, Bengaluru §Pulmonary Services, Kovai Medical Center, Coimbatore, India.
authors.forename: Karan
authors.initials: K
authors.lastname: Madan
authors.forename: Sahajal
authors.initials: S
authors.lastname: Dhooria
authors.forename: Inderpaul Singh
authors.initials: IS
authors.lastname: Sehgal
authors.forename: Anant
authors.initials: A
authors.lastname: Mohan
authors.forename: Ravindra
authors.initials: R
authors.lastname: Mehta
authors.forename: Vallandramam
authors.initials: V
authors.lastname: Pattabhiraman
authors.forename: Rajiv
authors.initials: R
authors.lastname: Goyal
authors.forename: Ritesh
authors.initials: R
authors.lastname: Agarwal
mesh_terms: D000402:Airway Obstruction / Q000601:surgery*; D001999:Bronchoscopy; D004867:Equipment Design; D004937:Esophageal Fistula / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000601:surgery; D012189:Retrospective Studies; D015607:Stents; D014135:Tracheal Stenosis / Q000601:surgery*; D016896:Treatment Outcome