Expandable metallic angioplasty
stents (Palmaz
stent) have been implanted in the trachea and/or bronchi of seven children. Three children had severe
tracheal stenosis after tracheoplasty for
congenital tracheal stenosis repair, and four had
tracheomalacia or
bronchomalacia with or without vascular compression. The mean age at stenting was 9.7 months (range, 2 to 15 months). Balloon expandable
stents were inserted into the trachea or bronchus through a 3.5-mm
bronchoscope under fluoroscopic control. Initially a single tracheal
stent was used for all patients except for one with obstruction in the trachea and both bronchi, in whom three
stents were implanted. Three children had recurrent
airway obstruction 1 month later; one was cured with a second
stent; one child died 1 year later; and the other is being treated for
heart disease. The others have no serious respiratory problems. The
stents in all have been in place for 1 to 25 (mean, 11) months. No immediate complications were noted. Early and late bronchoscopy showed incomplete epithelialization of the
stent and patches of granulation tissue on it. Two
stents were removed bronchoscopically, one at the completion of treatment for
tracheomalacia and the other at the time of recurrent
airway obstruction. This preliminary experience indicates that expandable metallic
stents have a useful role in the treatment of selected lower
airway obstructions.