Long-term outcomes of congenital tracheal stenosis treated by metallic airway stenting

Abstract

AimCongenital tracheal stenosis is an obstructive airway lesion that often presents as a life-threatening emergency. We had introduced the balloon dilatation and placement of the expandable metallic airway stent as a therapeutic option, and this study aimed to clarify the long-term outcomes in pediatric patients. MethodsA retrospective review of five infants in whom balloon expandable metallic airway stents (10–40mm long and 6–8mm in diameter) were inserted in 1997 to 2000 was conducted. ResultsThere was an immediate improvement of respiratory obstruction in all five infants (aged 7days to 12months) with four weaned from ventilation. One child died after 9months of palliative treatment. In all inflammation and granulation tissue developed over the stents, but this could be managed by scraping or balloon compression. Metallic stents have been in place a mean of 12years (range 6months to 13years) after insertion without other complications. Four children are alive and well with their stents in place. Recently, an attempt to remove the stent was done in two patients who showed dyspnea on exertion. They underwent tracheoplasty following successful complete removal of metallic stent using cardiopulmonary bypass. ConclusionUse of expandable metallic airway stents following balloon dilatation can be left for long periods to relieve tracheal obstruction. Development of granulation tissue is a major treatable complication. Removal of the stent was safely completed by open surgical intervention using a cardiopulmonary bypass. The airway stent may provide an important therapeutic option in selected cases with congenital tracheal stenosis.