Natural stent in the management of post-intubation tracheal stenosis.

Abstract

BACKGROUND AND OBJECTIVE:

The treatment choice for post-intubation tracheal stenosis (PITS) in patients for whom surgery is not initially feasible is bronchoscopic silicone stenting. A new silicone stent, called the Natural stent (N stent), was investigated for its clinical efficacy and safety in patients with PITS.

METHODS:

A retrospective review was conducted of 32 patients with PITS who underwent N stenting between November 2001 and December 2006 and were followed for at least 12 months.

RESULTS:

Airway dilatation with combined modalities such as Nd:YAG laser, ballooning or bougienage was followed by N stent insertion. After intervention, all patients had symptomatic and spirometric improvement without immediate complications. Removal of the stent without re-stenosis was successful in 38% of the patients at a median time of 7 months after insertion. The stent could not be removed or needed reinsertion in 31% of patients, and 16% of patients underwent surgery after initial stabilization by stenting. Late complications were stent migration (34%), mucostasis (31%), granulation tissue formation (38%) and re-stenosis (40%). All patients tolerated the management of complications during a median follow up of 22 months.

CONCLUSIONS:

Bronchoscopic N stenting is an effective treatment for patients with PITS in whom surgery is not feasible on initial presentation. Further stent development is necessary to reduce the late complication rate.

• Authors: Hye Yun Park, Hojoong Kim, Won-Jung Koh, Gee Young Suh, Man Pyo Chung, O Jung Kwon
• Journal: Respirology (Carlton, Vic.) (Respirology) Vol. 14 Issue 4 Pg. 583-8 (May 2009) ISSN: 1440-1843 [Electronic] Australia
• PMID: 19383113 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Silicones

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Bronchoscopy
• Cohort Studies
• Dilatation
• Equipment Design
• Female
• Humans
• Intubation, Intratracheal (adverse effects)
• Male
• Middle Aged
• Retrospective Studies
• Silicones
• Stents
• Tracheal Stenosis (etiology, pathology, therapy)
• Treatment Outcome
• Young Adult