TRANSBRONCHIAL PALMAZ STENT PLACEMENT FOR TRACHEOBRONCHIAL STENOSIS

PURPOSE: Evaluation of the efficacy of transbronchial Palmaz stent pla cement in the treatment of tracheo-bronchial narrowing. MATERIALS AND METHODS: Twelve patients with stenoses of the tracheo-bronchial tree w ere treated with balloon-expandable Palmaz stents, Etiology was anasto motic stenosis after lung transplantation (n = 3), bronchogenic carcin oma (n = 2) external compression from thoracic aortic aneurysm (n = 2) , Mycobacterium tuberculosis (n = 1), esophageal carcinoma (n = 1), af ter lobectomy (n = 1), after lobectomy and endobronchial radiation (n = 1), and lye ingestion (n = 1), All patients had respiratory symptoms , radiologic findings of persistent atelectasis, or worsening pulmonar y function tests, Bronchoscopy was used to delineate the stenosis prio r to intervention, With use of fluoroscopic guidance, stents were plac ed in the mainstem bronchus (n = 11), lower lobe bronchus (n = 5), bro nchus intermedius (n = 5), trachea (n = 3), and middle lobe bronchus ( n = 1). RESULTS: Initial technical success was achieved in all patient s, Ten of the 12 patients (83%) had improvement of clinical pulmonary signs or symptoms, During follow-up, five patients died, One was lost to follow-up and was presumed dead, The 30-day mortality rate was 17% (two of 12 patients), The two complications were superficial laceratio n of the bronchial mucosa during balloon dilation in one patient and c ompression of stents by a thoracic aortic aneurysm in another patient. CONCLUSION: Initial results suggest that transbronchial Palmaz stent placement is a feasible and effective method of treating tracheo-bronc hial stenosis.