Under general anesthesia, the patient underwent rigid bronchoscopy. The esophageal stent was seen through a large bronchoesophageal fistula in the proximal LMB (Fig 2, top left, A). On the right side, the airway stent was seen protruding through the medial wall of the RMB completely obstructing the BI (Fig 2, top left, A, and top right, B). Using rigid forceps, the airway stent was pulled out easily en bloc. At this point, the carinal anatomy was severely distorted, with bilateral bronchial wall perforations and a floppy middle portion. An attempt was therefore made to reconstruct the carina endoscopically with various airway prostheses. In the RMB, a 20 × 12 mm uncovered self-expanding stent (Ultraflex; Boston Scientific) was employed to restore the RMB/BI patency. On the left, a 40 × 14 mm covered stent (Ultraflex; Boston Scientific) was used to seal the LMB fistula. Finally, a silicone Y-stent (Dumon; Boston Medical Products; Westborough, MA) [tracheal limb, 20 × 14 mm; RMB limb, 15 × 10 mm; LMB limb, 20 × 10 mm] was telescoped into the bronchial stents to reinforce the lower trachea and proximal bronchi. The procedure was tolerated well by the patient, who had significant clinical improvement of her dyspnea and chest pain. In addition, a repeat CT scan of the chest (Fig 1, bottom left, C, and bottom right, D) confirmed the restoration of airway patency on the right side. She was discharged from the hospital to home shortly after completing a course of antibiotics with nutritional support provided exclusively via the gastrostomy tube. At follow-up 2 months later, the patient is still alive at home with no further hospitalization and with good control of her symptoms.