Bronchoscopic Extraction of Incorporated Self-Expanding Metallic Stents

摘要

Self-expanding metallic stents (SEMS) have gained widespread acceptance as a treatment for palliation malignant airway obstruction (MAO) in the terminally ill patient. Ease of deployment and excellent efficacy have allowed for rapid dissemination of SEMS. However, an unintended consequence has been the use SEMS as definitive treatment for benign tracheal stenosis, which also includes a unique cohort of patients with tracheomalacia and dynamic airway collapse. Unfortunately, patients with benign airway obstruction (BAO) often have lengthier projected lifespans than MAO patients, and consequently, live long enough to develop significant complications from SEMS. Complications from SEMS are frequently more difficult to treat than the index benign stenosis/malacia for which the patient was originally stented, and this has recently prompted government warnings about use of SEMS for BAO.