THE USE OF EXPANDABLE METALLIC AIRWAY STENTS FOR TRACHEOBRONCHIAL OBSTRUCTION IN CHILDREN

Expandable metallic angioplasty stents (Palmaz stent) have been implan ted in the trachea and/or bronchi of seven children. Three children ha d severe tracheal stenosis after tracheoplasty for congenital tracheal stenosis repair, and four had tracheomalacia or bronchomalacia with o r without vascular compression. The mean age at stenting was 9.7 month s (range, 2 to 15 months). Balloon expandable stents were inserted int o the trachea or bronchus through a 3.5-mm bronchoscope under fluorosc opic control. Initially a single tracheal stent was used for all patie nts except for one with obstruction in the trachea and both bronchi. i n whom three stents were implanted. Three children had recurrent airwa y obstruction 1 month later; one was cured with a second stent; one ch ild died 1 year later; and the other is being treated for heart diseas e. The others have no serious respiratory problems. The stents in all have been in place for 1 to 25 (mean, 11) months. No immediate complic ations were noted. Early and late bronchoscopy showed incomplete epith elialization of the stent and patches of granulation tissue on it. Two stents were removed bronchoscopically, one at the completion of treat ment for tracheomalacia and the other at the time of recurrent airway obstruction. This preliminary experience indicates that expandable met allic stents have a useful role in the treatment of selected lower air way obstructions. Copyright (C) 1995 by W.B. Saunders Company