Secondary carina Y-stent placement for post-lung-transplant bronchial stenosis

J Bronchology Interv Pulmonol. 2012 Apr;19(2):109-14. doi: 10.1097/LBR.0b013e31824f143f.

Abstract

Background: Post-lung-transplant bronchial stenosis (TBS) may cause significant morbidity and mortality. Although often transiently relieved by balloon bronchoplasty, stents may be required for long-term airway patency. We report a series of lung transplant patients in whom a silicone Y-stent was placed at the secondary carina for long-standing relief of post-transplant-airway stenosis.

Methods: Six lung transplant patients received 10 silicone Y-stents in the secondary carina over the past 18 months for post-transplant-bronchial stenosis. All patients failed other interventional therapeutic procedures including balloon bronchoplasty and/or conventional stenting before secondary carina Y-stent placement. Patient data include 12 months' follow-up after Y-stent insertion. The number of procedures and the interval between procedures was examined before and after secondary carina silicone Y-stent placement.

Results: There was a significantly prolonged therapeutic effect accomplished in these patients after secondary carina Y-stent placement with the exception of 1 patient. When stents were tolerated by the patient, the mean number of procedures before secondary carina Y-stent insertion was 15.6, but only 4.8 after Y-stent insertion. The number of days between procedures was 24.5 days before the Y-stent insertion and 85.8 days after the Y-stent insertion. There were no complications in any patient during secondary carina Y-stent insertion.

Conclusions: Secondary carina silicone Y-stent placement in TBS decreased the number of therapeutic procedures and provided longer-lasting results in most posttransplant patients who required multiple prior procedures for TBS.

MeSH terms

  • Bronchial Diseases / surgery*
  • Bronchoscopy / methods
  • Constriction, Pathologic / surgery
  • Device Removal
  • Humans
  • Lung Transplantation / adverse effects*
  • Postoperative Complications / surgery
  • Prospective Studies
  • Recurrence
  • Reoperation
  • Retrospective Studies
  • Stents*
  • Treatment Outcome