https://doi.org/10.4081/cdr.12.12731

Tracheal stent migration in malignant central airway obstruction – a case report and systematic review of literature

Vol. 12 (2024): Early Access
Submitted: 18 June 2024
Accepted: 16 July 2024
Published: 18 July 2024
Central Airway Obstruction, Self-Expanding Metallic Stent, esophageal ultrasound, controlled radial expansion
Abstract Views: 504
PDF: 137
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Manu Madan
https://orcid.org/0000-0001-9245-4568
Department of Pulmonary Critical Care & Sleep Medicine, VMMC & Safdarjung Hospital, New Delhi, India.
Sreyas Sharma
https://orcid.org/0009-0005-8156-5381
Department of Pulmonary Critical Care & Sleep Medicine, VMMC & Safdarjung Hospital, New Delhi, India.
Rohit Kumar
Department of Pulmonary Critical Care & Sleep Medicine, VMMC & Safdarjung Hospital, New Delhi, India.
Pranav Ish
Department of Pulmonary Critical Care & Sleep Medicine, VMMC & Safdarjung Hospital, New Delhi, India.
Rajnish Kaushik
Department of Pulmonary Critical Care & Sleep Medicine, VMMC & Safdarjung Hospital, New Delhi, India.
Nitesh Gupta
niteshgupta2107@gmail.com
Department of Pulmonary Critical Care & Sleep Medicine, VMMC & Safdarjung Hospital, New Delhi, India.

Airway stents are critical in maintaining airway patency and managing Central Airway Obstruction (CAO) caused by malignant and benign conditions. Despite their effectiveness, complications such as stent migration are common. We report a case of a 25-year-old female with malignant CAO, which was initially managed with an ultra-flex Self-Expanding Metal Stent (SEMS) followed by stent migration and subsequently interlocking SEMS with Y stent deployment. This case report highlights the complexity of managing malignant CAO. More research is needed to establish optimal practices for preventing stent migration and improving patient outcomes. A systematic review of the literature on airway stent migration was also conducted, revealing an incidence of 5-17%, with higher rates in tracheal stents. Factors such as lesion characteristics and location significantly impact migration risk. This review discusses the advantages and challenges of SEMS compared to silicone stents, emphasizing the need for tailored approaches in stent placement and fixation to mitigate migration risks.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Makkar P, Revelo A, Lee R, Chawla M. A single center experience of feasibility of a novel Self-Expanding Metallic Airway Stent (Bonastent): a case series. J Bronchology Interv Pulmonol. 2019;26:254-9. DOI: https://doi.org/10.1097/LBR.0000000000000603
Grosu HB, Eapen GA, Morice RC, et al. Stents are associated with an increased risk of respiratory infections in patients undergoing airway interventions for malignant airway disease. Chest. 2013;144:441-9. DOI: https://doi.org/10.1378/chest.12-1721
Huang S, Xu J, An Z, et al. Clinical assessment of airway stent placement in patients with malignant airway lesions. J Thorac Dis. 2018;10:3277-88. DOI: https://doi.org/10.21037/jtd.2018.06.01
Iyoda A, Azuma Y, Sano A, et al. Long-term survival of airway silicone stents in patients with central airway stenosis or obstruction due to thoracic malignancy. Gen Thorac Cardiovasc Surg. 2021;69:1303-7. DOI: https://doi.org/10.1007/s11748-021-01634-0
Marchese R, Poidomani G, Paglino G, et al. Fully covered self-expandable metal stent in tracheobronchial disorders: clinical experience. Respiration. 2015;89:49-56. DOI: https://doi.org/10.1159/000368614
Marchese R, Poidomani G, Palumbo VD, et al. Secondary carina and lobar bronchi stenting in patients with advanced lung cancer: is it worth the effort? A clinical experience. Ann Thorac Cardiovasc Surg. 2020;26:320-6. DOI: https://doi.org/10.5761/atcs.oa.19-00040
Marchioni A, Andrisani D, Tonelli R, et al. Integrated interventional bronchoscopy in treating locally advanced non-small lung cancer with central Malignant airway Obstructions: a multicentric retrospective study (EVERMORE). Lung Cancer. 2020;148:40-7. DOI: https://doi.org/10.1016/j.lungcan.2020.07.032
Miyazawa T, Miyazu Y, Iwamoto Y, et al. Stenting at the flow-limiting segment in tracheobronchial stenosis due to lung cancer. Am J Respir Crit Care Med. 2004;169:1096-102. DOI: https://doi.org/10.1164/rccm.200312-1784OC
Monnier P, Mudry A, Stanzel F, et al. The covered Wallstent is used for the palliative treatment of inoperable tracheobronchial cancers. A prospective, multicenter study. Chest. 1996;110:1161-8. DOI: https://doi.org/10.1378/chest.110.5.1161
Nakajima Y, Kurihara Y, Niimi H, et al. Efficacy and complications of the Gianturco-Z tracheobronchial stent for malignant airway stenosis. Cardiovasc Intervent Radiol. 1999;22:287-92. DOI: https://doi.org/10.1007/s002709900390
Razi SS, Lebovics RS, Schwartz G, et al. Timely airway stenting improves survival in patients with malignant central airway obstruction. Ann Thorac Surg. 2010;90:1088- 93. DOI: https://doi.org/10.1016/j.athoracsur.2010.06.093
Righini C, Aniwidyaningsih W, Ferretti G, et al. Computed tomography measurements for airway stent insertion in malignant airway obstruction. J Bronchology Interv Pulmonol. 2010;17:22-8. DOI: https://doi.org/10.1097/LBR.0b013e3181ccadbe
Akram MJ, Khalid U, Abu Bakar M, et al. Indications and clinical outcomes of fully covered self-expandable metallic tracheobronchial stents in patients with malignant airway diseases. Expert Rev Respir Med. 2020;14:1173-81. DOI: https://doi.org/10.1080/17476348.2020.1796642
Bolliger CT, Breitenbuecher A, Brutsche M, et al. Use of studded Polyflex stents in patients with neoplastic obstructions of the central airways. Respiration. 2004;71:83-7. DOI: https://doi.org/10.1159/000075654
Chhajed PN, Somandin S, Baty F, et al. Therapeutic bronchoscopy for malignant airway stenoses: choice of modality and survival. J Cancer Res Ther. 2010;6:204-9. DOI: https://doi.org/10.4103/0973-1482.65250
Zakaluzny SA, Lane JD, Mair EA. Complications of tracheobronchial airway stents. Otolaryngol Head Neck Surg. 2003;128:478-88. DOI: https://doi.org/10.1016/S0194-59980300002-0
Wahidi MM, Herth FJF, Chen A, et al. State of the art: interventional pulmonology. Chest. 2020;157:724-36. DOI: https://doi.org/10.1016/j.chest.2019.10.013
Ehab A, Hagemann M. Internal fixation of the proximal tracheal self-expandable metallic stent (SEMS): migration prevention in high-risk patients. J Thorac Dis. 2020;12:3211-6. DOI: https://doi.org/10.21037/jtd-20-642

How to Cite

Madan, M., Sharma, S., Kumar, R., Ish, P., Kaushik, R., & Gupta, N. (2024). Tracheal stent migration in malignant central airway obstruction – a case report and systematic review of literature. Chest Disease Reports, 12(1). https://doi.org/10.4081/cdr.12.12731
Copyright (c) 2024 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.