Benign and Malignant Tracheobronchial Strictures:Long Term Follow-up of Treatment with Polyurethane-Covered Retrievable Expandable Nitinol Stents strictures

ABSTRACT

PURPOSE: To assess the safety and long term effectiveness of polyurethane-covered retrievable expandable nitinol stents in the treatment of benign and malignant tracheobronchial strictures. MATERIALS AND METHODS: Under fluoroscopic guidance, the stents were placed in 32 patients with dyspnea whose strictures were malignant in 15 cases and benign in 17. A stent was removed when complications occurred,or -electively- 2-6 months after placement in patients with benign strictures. The range of follow-up period was 1 -98 weeks (median, 47; range, 50) weeks. RESULTS: Stent placement was well tolerated in 30 patients. After placement, all 32 showed immediate symptom improvement and in none were complications such as ingrowth of a tumor or granulation tissue observed during the follow up period. Stent migration occurred in six patients. In one of six and four of five patients from whom, respectively, stents had been electively removed two and six months after placement, tracheo-bronchial restenosis did not occur during follow up. Second stents were placed in six patients in whom dyspnea recurred due to restenosis after elective stent removal. In two of these six, stents were removed six months after placement and dyspnea did not recur during follow up. CONCLUSION: The use of covered retrievable tracheobronchial stents is safe and feasible in the conservative treatment of patients with malignant tracheobronchial strictures as well as for selected patients with benign strictures.