Rigid bronchoscopic management of complications related to endobronchial stents after lung transplantation.

OBJECTIVES

We reviewed the utility of rigid bronchoscopy in the management of complications resulting from placement of metallic endobronchial stents after lung transplantation.

METHODS

A retrospective review was performed of all lung transplant patients who required metallic endobronchial stenting between 2005 and 2009. The patients' medical records were reviewed, and details regarding stent placement, complications, and removal were recorded.

RESULTS

A total of 43 metallic stents were placed in 22 patients who had unilateral or bilateral lung transplantation. Stent complications occurred in 18 cases (42%) at a mean of 285 days after placement and included stent collapse, stent breakdown, stent migration, ingrowth of granulation tissue, and coughing up of fractured pieces of stent. Of the 43 stents placed, only 4 (9%) had to be removed. Removal was readily accomplished by rigid bronchoscopic techniques, even when some endothelial ingrowth had occurred.

CONCLUSIONS

Lung transplantation presents unique challenges in airway management. Endobronchial stenting plays an important role in the management of anastomotic stenosis and bronchomalacia in these patients. Although metallic stents have significant advantages, complications often arise that occasionally necessitate their removal. Rigid bronchoscopy is a valuable tool in the management of endobronchial stent complications after lung transplantation.