Short-term deployment of self-expanding metallic stents facilitates healing of bronchial dehiscence

Majid M. Mughal, Thomas R. Gildea, Sudish Murthy, Gosta Pettersson, Malcom DeCamp, Atul C. Mehta*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

100 Scopus citations

Abstract

Bronchial dehiscence after lung transplantation is difficult to treat and associated with high mortality. We describe our experience using self-expanding metallic stents to treat post-lung transplant bronchial dehiscence. From January 1995 to June 2004, 189 single and 118 double lung transplants were performed in our institution, totaling 425 at-risk bronchial anastomoses. Seven (1.6%) incidents of life-threatening bronchial dehiscence were treated with self-expanding metallic stents. The interval between transplant and diagnosis of dehiscence was 29.1 ± 18.5 days. All patients presented with respiratory distress, and three required mechanical ventilation. Self-expanding metallic stent placement resulted in complete bronchial healing. All three patients with respiratory failure requiring mechanical ventilation were successfully weaned after stent placement. In two later cases, the stents were electively removed after adequate healing of the dehiscence. Complications included stent migration (one patient) and in-stent stenosis (three patients). Two of these patients required repeat stent insertion after removal, due to bronchomalacia. In patients with life-threatening bronchial dehiscence, self-expanding metallic stents offer prospects for a successful outcome. Self-expanding metallic stents are known to be associated with significant granulation tissue formation, and this property provides a platform for healing of dehiscence and, in time, peribronchial soft tissue grows in to cover the defect, allowing stent removal.

Original languageEnglish (US)
Pages (from-to)768-771
Number of pages4
JournalAmerican journal of respiratory and critical care medicine
Volume172
Issue number6
DOIs
StatePublished - Sep 15 2005

Keywords

  • Bronchial dehiscence
  • Lung transplantation
  • Metallic stents

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Fingerprint Dive into the research topics of 'Short-term deployment of self-expanding metallic stents facilitates healing of bronchial dehiscence'. Together they form a unique fingerprint.

Cite this