SELF-EXPANDING STENTS IN THE TREATMENT OF TRACHEOBRONCHIAL OBSTRUCTION

The self-expandable stainless steel stents (Gianturco, William Cook, B jaeverskov, Denmark) used extensively in biliary ducts and the vascula r system have recently been modified for use in the tracheobronchial t ree. Between March 1991 and September 1992, six patients with unresect able tracheobronchial and mediastinal diseases were treated with the p lacement of one or more self-expanding stents under direct vision with a fiberoptic bronchoscope. All patients had been intubated for severe respiratory insufficiency. In all cases, immediate relief of respirat ory symptoms was achieved and all patients were extubated 1 or 2 days after stent placement. Tolerance of the stents was excellent. No patie nt complained of pain, discomfort, or foreign body sensation. No infec tion or obstruction of the stents was observed. The chest roentgenogra m and the bronchoscopies performed during follow-up have shown no chan ge in the position of the stents. Our results seem promising since the se devices provide effective palliation of airway obstructions and are well tolerated.