SELF-EXPANDING METAL STENTS FOR THE MANAGEMENT OF BRONCHIAL STENOSIS AND BRONCHOMALACIA AFTER LUNG TRANSPLANTATION

Background: Airway stenosis or malacia after lung transplantation, usu ally as a result of anastomotic ischemia, remains a major problem. Met hods: The authors report their experience with the Gianturco expandabl e stent for the management of 23 bronchial stenoses in 18 patients fol lowing lung transplantation. Stent placement occurred an average of 5. 6 months after transplantation. Results: Stents were well tolerated an d produced immediate symptomatic and functional improvement. The mean follow-up after implantation was 21 months (range, 4 to 48 mo). The au thors removed five stents by endoscopy and replaced them, and removed one stent entirely. Laser resection was used to control granulomas or partial fibrosis stenosis that occurred in four stents (14.3%) after a n average of 4 months. One stent broke but was still in place and effe ctive 32 months later. One patient died of hemorrhage 4 months after s tenting. Conclusion: Although it can still be improved, this expandabl e metal stent is suitable for the treatment of posttransplantation pro ximal bronchial stenosis, Key Words: Bronchial stenosis, bronchomalaci a, stent, lung transplantation.