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Ann Thorac Surg 2000;70:1191-1193
© 2000 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery, St George’s Hospital, London, England, UK
b Department of Cardiological Science, St George’s Hospital, London, England, UK
Address reprint requests to Dr Madden, Department of Cardiothoracic Surgery, St George’s Hospital, Blackshaw Road, Tooting, London SW17 0QT, England
Background. Tracheal obstruction secondary to benign proliferation of granulation tissue is a difficult problem to address if tracheal resection is contraindicated. Some patients may benefit from Nd:YAG (neodymium:yttritium-aluminum garnet) laser fulguration or tracheal stenting. If uncovered expandable metallic stents are employed granulation tissue can regrow and proliferate through the mesh, thereby obstructing the lumen once again. Covered metallic stents confer the advantage of preventing granulation tissue proliferation and therefore maintain patency of the tracheal lumen.
Methods. Two patients who developed tracheal obstruction secondary to proliferating granulation tissue formation after tracheostomy and who were medically unfit for prolonged general anesthesia were successfully treated using covered expandable metallic tracheal stents.
Results. Each patient demonstrated a significant improvement in respiratory status, and in both patients, at 6 and 9 months’ follow-up, stent position has not changed, tracheal lumen remains patent, and there has been no proliferation of granulation tissue through the stent.
Conclusions. Covered expandable metallic stents should be considered in the management of patients with proliferating tracheal granulation tissue when tracheal resection is contraindicated.
This article has been cited by other articles:
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B. Madden and A. Sheth Reply Ann. Thorac. Surg., December 1, 2005; 80(6): 2419 - 2420. [Full Text] [PDF]
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B. P. Madden, J. E. S. Park, and A. Sheth Medium-Term Follow-Up After Deployment of Ultraflex Expandable Metallic Stents to Manage Endobronchial Pathology Ann. Thorac. Surg., December 1, 2004; 78(6): 1898 - 1902. [Abstract] [Full Text] [PDF]
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B. P. Madden, A. Sheth, T. B. L. Ho, and G. McAnulty Novel approach to management of a posterior tracheal tear complicating percutaneous tracheostomy Br. J. Anaesth., March 1, 2004; 92(3): 437 - 439. [Abstract] [Full Text] [PDF]
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