Expandable metal stents as an alternative treatment of cuff-related tracheal stenosis in tracheostomy-dependent ventilated patients: a prospective study of nine cases and description of the complications

Abstract

In long-term intubated patients, cuff-related tracheal injury is occasionally complicated by tracheal stricture. To keep the airway patent, bougienage and deployment of stents are adopted in patients unfit for surgery. Prospectively, nine episodes of cuff-related tracheal stricture in nine tracheostomy-dependent ventilated patients were treated with pre-stenting bougienage, followed by implantation of expandable metal stents (EMS). The primary endpoint of this study was the successful discharge of the patients back to the chronic care unit. The other endpoint was the re-treatment rate. The mean age of the nine patients was 61.7 years. The follow-up period was 18.6 months. The first two patients received a bare stent, and the other seven patients received membrane-coated stents. They all recovered well with successful discharge back to the chronic care unit. There were two episodes of granulation formation in one bare-stent patient and in one coated-stent patient, respectively. In another coated-stent patient, complications arose from a broken stent. EMS appears to have a role to play in tracheostomy-dependent ventilated patients with benign tracheal stenoses in whom there are no other reasonable options.