To evaluate the effectiveness of airway stents in the treatment of diffuse tracheobronchomalcia (TBM) and their complications.
Single center retrospective analysis of medical records from patients with diffuse TBM referred to a major academic center from January 2002 to June 2004 who underwent central airway stenting (tracheal, main bronchus or both). Patient charts were reviewed for improvement of symptoms and complications.
Number of patients stented: 29; number of patients with improvement of symptoms: 23(80%), without improvement of symptoms 6(20%); how did symptoms improve: off mechanical ventilation 4 (17%), less cough 12(52%), less shortness of breath 17(74%), less medications 4(17%); number of complications:24 (83%),time of complications: <3 months 20 (83%), >3months 4(17%), median 26 days (3-865 days); procedure related: 3(13%), stent related:21(87%) (infection 6(29%), migration 6(29%), obstruction 12(57%), breakage 1(5%),hemoptysis 1(5%),respiratory failure 2(10%), cough 2(10%)).
Silicone stents improve symptoms in carefully selected patients with moderate to severe TBM. Unfortunately, treatment with these stents is associated with a significant number of short and long-term complications that limits their use.
Airway stents currently have a role in identifying patients with diffuse TBM who will benefit from central airway stabilization.
Adnan Majid, None.