Broncho-vascular fistulas from self-expanding metallic stents: A retrospective case review

Choudhary, Chirag; Bandyopadhyay, Debabrata; Salman, Reyadh; Gildea, Thomas R.; Mehta, Atul C.

doi:10.4103/1817-1737.109830

Cited by 8 publications

(7 citation statements)

References 21 publications

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“…In many reports, self-expanding metallic stents have a lower rate of migration and hemoptysis, but a higher rate of granulation as compared with silicone stents [5–7]. There are also several additional complications including stent fracture, trachea/broncho-esophageal fistula [8], broncho-vascular fistula [9], and difficulty in removal. Removal of metallic stents can also result in serious complications, including mucosal tears and severe bleeding.…”

Section: Discussionmentioning

confidence: 99%

Bronchial artery aneurysm suggested to be caused by metalic tracheal stent migration

et al. 2016

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Occurrence of bronchial artery aneurysm is rare, and it has been detected in less than 1 % of all selective bronchial arteriography cases. Here, we present a case of a bronchial artery aneurysm caused by a tracheal stent migration. A 59-year-old man was operated on for esophageal cancer, where an esophageal-tracheal fistula occurred 1 week after operation. Surgical repair of the esophageal-tracheal fistula was performed using a muscle flap, but this not results in fistula closure. Consequently, a self-expanding covered metallic tracheal stent was implanted for rescue, and this resulted in fistula closure. After 1 year, there was frequent hemoptysis caused by migration of the stent. He was referred to our hospital where removal of the stent was planned. A sudden occurrence of massive bleeding from trachea occurred, and extracorporeal membrane oxygenation (ECMO) was used. Although removal of tracheal stent was performed successfully, the patient subsequently died from multi-organ failure. Post-mortem autopsy revealed that the massive bleeding is originated from the rupture of a bronchial artery aneurysm.

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Section: Discussionmentioning

confidence: 99%

Bronchial artery aneurysm suggested to be caused by metalic tracheal stent migration

et al. 2016

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“…Serious complications have been reported, including airway or vascular perforation (20). Also concerning is the fact that complications of metallic stents tend to occur more frequently in benign diseases, for reasons previously described.…”

Section: Metallic and Hybrid Stentsmentioning

confidence: 96%

Airway stents

Folch¹,

Keyes²

2018

Ann. Cardiothorac. Surg.

148

135

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Stents and tubes to maintain the patency of the airways are commonly used for malignant obstruction and are occasionally employed in benign disease. Malignant airway obstruction usually results from direct involvement of bronchogenic carcinoma, or by extension of carcinomas occurring in the esophagus or the thyroid. External compression from lymph nodes or metastatic disease from other organs can also cause central airway obstruction. Most malignant airway lesions are surgically inoperable due to advanced disease stage and require multimodality palliation, including stent placement. As with any other medical device, stents have significantly evolved over the last 50 years and deserve an in-depth understanding of their true capabilities and complications. Not every silicone stent is created equal and the same holds for metallic stents.Herein, we present an overview of the topic as well as some of the more practical and controversial issues surrounding airway stents. We also try to dispel the myths surrounding stent removal and their supposed use only in central airways. At the end, we come to the long-held conclusion that stents should not be used as first line treatment of choice, but after ruling out the possibility of curative surgical resection or repair.

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“…Notable disadvantages to metal stents include a much higher incidence of granulation or tumor ingrowth, erosion or perforation, and fracture from metal fatigue. 28 36 98 106 107 Without close follow-up and surveillance bronchoscopy, uncovered metal stents may become fully epithelialized or ingrown, leading to airway obstruction. Although most data on this subject come from the benign CAO literature, extraction of embedded metal airway stents may be risky, challenging, or even impossible.…”

Section: Bronchoscopic Interventions For Malignant Central Airway Obs...mentioning

confidence: 99%

Malignant Central Airway Obstruction: What's New?

Shaller

Filsoof

Pineda

et al. 2022

Semin Respir Crit Care Med

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Malignant central airway obstruction (MCAO) is a debilitating and life-limiting complication that occurs in an unfortunately large number of individuals with advanced intrathoracic cancer. Although the management of MCAO is multimodal and interdisciplinary, the task of providing patients with prompt palliation falls increasingly on the shoulders of interventional pulmonologists. While a variety of tools and techniques are available for the management of malignant obstructive lesions, advancements and evolution in this therapeutic venue have been somewhat sluggish and limited when compared with other branches of interventional pulmonary medicine (e.g., the early diagnosis of peripheral lung nodules). Indeed, one pragmatic, albeit somewhat uncharitable, reading of this article's title might suggest a wry smile and shug of the shoulders as to imply that relatively little has changed in recent years. That said, the spectrum of interventions for MCAO continues to expand, even if at a less impressive clip. Herein, we present on MCAO and its endoscopic and nonendoscopic management-that which is old, that which is new, and that which is still on the horizon.

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Broncho-vascular fistulas from self-expanding metallic stents: A retrospective case review

Cited by 8 publications

References 21 publications

Bronchial artery aneurysm suggested to be caused by metalic tracheal stent migration

Bronchial artery aneurysm suggested to be caused by metalic tracheal stent migration

Airway stents

Malignant Central Airway Obstruction: What's New?

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