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  • Title: Factors leading to tracheobronchial self-expandable metallic stent fracture.
    Author: Chung FT, Lin SM, Chen HC, Chou CL, Yu CT, Liu CY, Wang CH, Lin HC, Huang CD, Kuo HP.
    Journal: J Thorac Cardiovasc Surg; 2008 Nov; 136(5):1328-35. PubMed ID: 19026824.
    Abstract:
    OBJECTIVE: This retrospective study was to determine factors that contribute to self-expandable metallic stent fracture in patients with tracheobronchial disease. METHODS: From 2001 to 2006, 139 patients (age, 62.1 +/- 15.4 years; range, 23-87 years) with benign (n = 62) and malignant (n = 77) tracheobronchial disease received 192 Ultraflex (Boston Scientific, Natick, Mass) self-expandable metallic stents (98 in patients with benign disease and 94 in patients with malignant disease). RESULTS: Seventeen fractured self-expandable metallic stents were found; the incidence was 12.2% (17/139 patients) among patients with tracheobronchial disease. Tortuous airway (odds ratio, 4.06; 95% confidence interval, 1.04-18.34; P = .04) independently predicted self-expandable metallic stent fracture. Most self-expandable metallic stent fractures (64.7%, 11/17) were detected 500 to 1000 days after self-expandable metallic stent implantation. Clinical presentations for patients with fractured self-expandable metallic stents included dyspnea exacerbation (70.6%, 12/17) and cough (23.5%, 4/17). CONCLUSIONS: Self-expandable metallic stent fracture is not uncommon in patients with tracheobronchial disease. Tortuous airway is an independent predictor for it. Although management of the fractured self-expandable metallic stent in our study was feasible and safe, self-expandable metallic stents should be restricted to a more select population.
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