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Case Reports

Management of Tracheomediastinal Fistula Using Self-Expanding Metallic Stents

Department of Pulmonary, Allergy, and Critical Care Medicine, Cleveland Clinic, Cleveland, Ohio

Accepted for publication November 2, 2007.

^_* Address correspondences to Dr Gildea, Department of Pulmonary, Allergy, and Critical Care Medicine, A-90, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195 (Email: gildeat{at}ccf.org).

Tracheomediastinal fistula is a rare condition usually associated with a fatal outcome. We report the case of a 65-year-old man with a subcarinal mass causing total destruction of the carina and proximal mainstem bronchi. The mass was diagnosed as a large cell lymphoma, and the decision was made to undertake chemotherapy only after stabilization of the endobronchial tree. The endobronchial defects were successfully palliated with placement of three different types of self-expanding metallic stents using a flexible bronchoscope under conscious sedation. The unique properties of each stent were used for optimum clinical benefit, avoiding any morbidity.