Tracheal Obstruction Caused by an Expandable Metallic Stent: a Case of Successful Removal of the Stent

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2005 Jul 13

PMID 16010548

Citations 3

Authors

Hiroomi Okuyama

Akio Kubota

Hisayoshi Kawahara

Takaharu Oue

Satoko Nose

Toshiyuki Ihara

Affiliations

Soon will be listed here.

Abstract

We report a case of tracheal obstruction caused by an expandable metallic stent. A 3-month-old girl with severe tracheomalacia had a placement of a Palmaz stent. At 3 years of age, she developed progressive dyspnea. The CT scan showed tracheal obstruction caused by granulation tissue over the stent. At operation, the stent was found to have penetrated the posterior tracheal wall. Under partial cardiopulmonary bypass, the stent was removed along with the membranous wall of the trachea, and the trachea was reconstructed using slide tracheoplasty. Tracheal obstruction is one of the serious complications caused by an expandable metallic stent. Direct open approach to the trachea under cardiopulmonary bypass is thought to be a safe way to manage this problem.

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References

Abdel-Rahman U, Ahrens P, Fieguth H, Kitz R, Heller K, Moritz A . Surgical treatment of tracheomalacia by bronchoscopic monitored aortopexy in infants and children. Ann Thorac Surg. 2002; 74(2):315-9. DOI: 10.1016/s0003-4975(02)03642-1. View

FILLER R, Forte V, Chait P . Tracheobronchial stenting for the treatment of airway obstruction. J Pediatr Surg. 1998; 33(2):304-11. DOI: 10.1016/s0022-3468(98)90452-3. View

Davis S, Jones M, Kisling J, Angelicchio C, Tepper R . Effect of continuous positive airway pressure on forced expiratory flows in infants with tracheomalacia. Am J Respir Crit Care Med. 1998; 158(1):148-52. DOI: 10.1164/ajrccm.158.1.9711034. View

Kao S, Chang W, Pong M, Cheng K, Chan K, Tsai S . Welded tracheal stent removal in a child under cardiopulmonary bypass. Br J Anaesth. 2003; 91(2):294-6. DOI: 10.1093/bja/aeg152. View

Corno A, Giamberti A, Giannico S, Marino B, Rossi E, Marcelletti C . Airway obstructions associated with congenital heart disease in infancy. J Thorac Cardiovasc Surg. 1990; 99(6):1091-8. View

FILLER R, Forte V, Fraga J, Matute J . The use of expandable metallic airway stents for tracheobronchial obstruction in children. J Pediatr Surg. 1995; 30(7):1050-5; discussion 1055-6. DOI: 10.1016/0022-3468(95)90340-2. View

Miyamoto T, Ishida R, Noma M, Chikada M, Sekiguchi A . Successful surgical management of a tracheopulmonary artery fistula caused by an intratracheal expandable metal stent. Jpn J Thorac Cardiovasc Surg. 2001; 49(10):632-4. DOI: 10.1007/BF02916230. View

Alfaro J, Varela G, Martin de Nicolas J . Successful management of a tracheo-innominate artery fistula following placement of a wire self-expandable tracheal Gianturco stent. Eur J Cardiothorac Surg. 1993; 7(11):615-6. DOI: 10.1016/1010-7940(93)90250-f. View

FURMAN R, Backer C, Dunham M, Donaldson J, Mavroudis C, Holinger L . The use of balloon-expandable metallic stents in the treatment of pediatric tracheomalacia and bronchomalacia. Arch Otolaryngol Head Neck Surg. 1999; 125(2):203-7. DOI: 10.1001/archotol.125.2.203. View

10.

Cook C, Bhattacharyya N, King D . Aortobronchial fistula after expandable metal stent insertion for pediatric bronchomalacia. J Pediatr Surg. 1998; 33(8):1306-8. DOI: 10.1016/s0022-3468(98)90175-0. View

11.

Tazuke Y, Kawahara H, Yagi M, Yoneda A, Soh H, Maeda K . Use of a Palmaz stent for tracheomalacia: case report of an infant with esophageal atresia. J Pediatr Surg. 1999; 34(8):1291-3. DOI: 10.1016/s0022-3468(99)90174-4. View

12.

Maeda K, Yasufuku M, Yamamoto T . A new approach to the treatment of congenital tracheal stenosis: Balloon tracheoplasty and expandable metallic stenting. J Pediatr Surg. 2001; 36(11):1646-9. DOI: 10.1053/jpsu.2001.27940. View