To the Editor: The Bonastent (EndoChoice Inc., Alpharetta, GA) is a novel member of the class of self-expanding metal stents (SEMS) used to manage airway obstruction of both benign and malignant etiologies. The incidence of Bonastent-related complications has been reported as high as 40% and includes stent migration, fracture, obstruction due to granulation tissue formation, tumor ingrowth, or reduced mucociliary clearance. This is comparable to complication rates noted in other SEMS. To our knowledge, there is only 1 report of fracture of the Bonastent in pulmonary literature. Furthermore, despite the frequent use of SEMS as a treatment for malignant central airway obstruction or management of radiation-induced tracheal stenosis, there are no reports of stenting before external beam radiation therapy. We present the first report of a prophylactic Bonastent and its subsequent fracture, which required extraction with flexible bronchoscopy.
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