Central airway obstruction treatment with self-expanding covered Y-carina nitinol stents: A single center retrospective analysis

Thorac Cancer. 2022 Apr;13(7):1040-1049. doi: 10.1111/1759-7714.14359. Epub 2022 Feb 24.

Abstract

Background: Central airway obstruction (CAO) is one of the most challenging, potentially lethal complications in malignant and benign respiratory diseases. Worsening dyspnea is also a relevant cause for reduced quality of life in such patients. Here, we present our data on the application of covered, self-expanding Y-carina nitinol stents due to benign and malignant diseases.

Methods: We retrospectively identified 27 patients who had undergone 31 rigid bronchoscopies with implantation of covered Y-carina nitinol stents over a period of 10 years in order to evaluate indication, clinical course, and outcome.

Results: Short-term survival of successfully stented patients with palliative and curative treatment goal did not differ, allowing for diagnosis independent indication. With respect to overall survival, patients with endoluminal obstruction benefited most compared to patients with fistula and/or external compression. Granulation tissue formation (61.3%) and mucus plugging (80.6%) were the most frequent complications. Material defect (6.5%) and migration (3.2%) were rare complications that could be handled by revisional rigid bronchoscopy and stent exchange in some cases.

Conclusions: Implantation of self-expanding covered Y-carina nitinol stents via rigid bronchoscopy is a feasible and safe treatment option for benign and malignant central airway obstruction. Especially in palliative, malignant airway stenosis, stenting might facilitate additional treatment options and optimize dyspnea and eventually quality of life.

Keywords: CAO; bronchial stent; nitinol Y-carina stent; self-expanding stent.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Airway Obstruction* / etiology
  • Airway Obstruction* / surgery
  • Alloys
  • Bronchoscopy / methods
  • Humans
  • Quality of Life*
  • Retrospective Studies
  • Stents / adverse effects
  • Treatment Outcome

Substances

  • Alloys
  • nitinol