Covered Balloon-Expanding Stents in Airway Stenosis.
BACKGROUND
The balloon-expanding stents are widely available but rarely described for use within the tracheobronchial tree. This report describes our experience with these stents in airway stenosis particularly as a lobar salvage therapy.


METHODS
This was a retrospective review of all records in which the balloon-expanding stents were used at a tertiary medical center. Ages, sex, location of stenosis, etiology of stenosis, stent size, duration of stent placement and associated interventions for airway stenosis were recorded. Patient's self-reported respiratory symptoms, dyspnea scale, and radiographic imaging at baseline and after stent placement were also reported.


RESULTS
Twenty-one Atrium iCAST stents were inserted in 18 patients with malignant and benign airway disease. The median age was 69.5 years (interquartile range, 53.5 to 74). Most stents (n=20, 95%) were deployed in the lobar airways. There was a significant improvement in the modified Medical Research Council dyspnea scale from median of 3 to 2 (P<0.05). Self-reported respiratory symptoms improved in 14 patients (78%, P<0.05). Radiographic improvement post Atrium iCAST stent placement was achieved in 15 patients (83%). No deaths were related to airway stenting complications. Adverse events related to stents included migration (n=2, 9.5%), granulation tissue formation (n=2, 9.5%) and mucus plugging (n=1, 4.8%).


CONCLUSIONS
Lobar stenting with balloon-expanding metallic stents appears feasible, safe and improves symptoms as well as radiographic atelectasis in patients with lobar airway stenosis in this small case series. Larger studies are needed to confirm this observation and to address long-term safety.
*Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center ¶Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA †Division of Pulmonary Diseases, Critical Care and Environmental Medicine, Tulane University Health Sciences Center, New Orleans, LA ‡Interventional Pulmonology, California Pacific Medical Center, San Francisco ∥Interventional Pulmonology, University of California, Los Angeles, CA §Interventional Pulmonology, Lenox Hill Hospital, New York, NY.
Adnan
A
Majid
Fayez
F
Kheir
Jey
J
Chung
Daniel
D
Alape
Bryan
B
Husta
Scott
S
Oh
Erik
E
Folch
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D062606:Tertiary Care Centers; D019616:Thoracic Surgical Procedures / Q000295:instrumentation*; D014135:Tracheal Stenosis / Q000601:surgery*; D016896:Treatment Outcome