The Journal of Heart and Lung Transplantation
Volume 28, Issue 7 , Pages 683-688 , July 2009

Clinical Experience With a New Removable Tracheobronchial Stent in the Management of Airway Complications After Lung Transplantation

Received 5 January 2009 ,Revised 13 March 2009 ,Accepted 9 April 2009.

References 

  1. Shennib H, Massard G. Airway complications in lung transplantation. Ann Thorac Surg. 1994;57:506–511
  2. Takao M, Katayama Y, Onoda K, et al. Significance of bronchial mucosal blood flow for the monitoring of acute rejection in lung transplantation. J Heart Lung Transplant. 1991;10:956–967
  3. Kshettry VR, Kroshus TJ, Hertz MI, et al. Early and late airway complications after lung transplantation: incidence and management. Ann Thorac Surg. 1997;63:1576–1583
  4. Schafers HJ, Haydock DA, Cooper JD. The prevalence and management of bronchial anastomotic complications in lung transplantation. J Thorac Cardiovasc Surg. 1991;101:1044–1052
  5. Wilson IC, Hasan A, Healey M, et al. Healing of the bronchus in pulmonary transplantation. Eur J Cardiothorac Surg. 1996;10:521–527
  6. Date H, Trulock EP, Arcidi JM, et al. Improved airway healing after transplantation (An analysis of 348 bronchial anastomosis). J Thorac Cardiovasc Surg. 1995;110:1424–1433
  7. Griffith BP, Magee MJ, Gonzalez IF, et al. Anastomotic pitfalls in lung transplantation. J Thorac Cardiovasc Surg. 1994;107:743–753
  8. Schafers HJ, Haverich A, Wagner TO, et al. Decreased incidence of bronchial complications following lung transplantation. Eur J Cardiothorac Surg. 1992;6:174–179
  9. Schmid RA, Boehler A, Speich R, et al. Bronchial anastomotic complications following lung transplantation: still a major cause of morbidity?. Eur Respir J. 1997;10:2872–2875
  10. Patel SR, Kirby TJ, McCarthy PM, et al. Lung transplantation: the Cleveland Clinic experience. Cleve Clin J Med. 1993;60:303–319
  11. Lonchyna VA, Arcidi JM, Garrity ER, et al. Refractory post-transplant airway strictures: successful management with wire stents. Eur J Cardiothorac Surg. 1999;16:842–849
  12. Siegelman SS, Hagstrom JWC, Koerner SK, Veith FJ. Restoration of bronchial artery circulation after canine lung allo-transplantation. J Thorac Cardiovasc Surg. 1977;73:792–795
  13. Barman SA, Ardell JL, Parker JC, Perry ML, Taylor AE. Pulmonary and systemic blood flow contributions to upper airway in canine lung. Am J Physiol Heart Circ Physiol. 1988;255:H1130–H1135
  14. Mills NL, Boyd AD, Gheranpong C. The significance of bronchial circulation in lung transplantation. J Thorac Cardiovasc Surg. 1970;60:866–878
  15. Couraud L, Baudet E, Nashef SAM, et al. Lung transplantation with bronchial revascularization. Eur J Cardiothorac Surg. 1992;6:490–495
  16. Pinsker KL, Koerner SK, Kamholz SL, Hagtrom JW, Veith FJ. Effect of donor bronchial length on healing: a canine model to evaluate bronchial anastomotic problems in lung transplantation. J Thorac Cardiovasc Surg. 1979;77:669–673
  17. Morgan E, Lima O, Goldberg M, et al. Successful revascularization of totally ischemic bronchial autograft with omental pedicle flaps in dogs. J Thorac Cardiovasc Surg. 1982;84:204–210
  18. Fell SC, Mollenkopf FP, Montefusco CM, et al. Revascularization of ischemic bronchial anastomosis by an intercostal pedicle flap. J Thorac Cardiovasc Surg. 1985;90:172–178
  19. Calhoon JH, Grover FL, Gibbons WJ, et al. Single lung transplantation (Alternate indications and technique). J Thorac Cardiovasc Surg. 1991;101:816–825
  20. Veith FJ, Richards K. Improved technique for canine lung transplantation. Ann Surg. 1970;171:553–558
  21. Novick RJ, Ahmad D, Menkins AH, et al. The importance of acquired diffuse bronchomalacia in heart-lung transplant recipients with obliterative bronchiolitis. J Thorac Cardiovasc Surg. 1991;101:643–648
  22. Anzueto A, Levine SM, Tillis WP, Calhoon JH, Bryan CL. Use of the flow-volume loop in the diagnosis of bronchial stenosis after single lung transplantation. Chest. 1994;105:934–936
  23. Neagos GR, Martinez FJ, Deeb GM, et al. Diagnosis of unilateral main stem bronchial obstruction following single-lumen transplantation with routine spirometry. Chest. 1993;103:1255–1258
  24. Sonnet JR, Conte JV, Orens J, Krasna M. Removal and repositioning of permanent expandable wire stents in bronchial airway stenosis after lung transplantation. J Heart Lung Transplant. 1998;17:328–330
  25. Gaer JA, Tsang V, Khaghani A, et al. Use of endotracheal silicone stents to relief of tracheobronchial obstruction. Ann Thoracic Surg. 1992;54:512–516
  26. Cooper JD, Pearson FG, Patterson GA, et al. Use of silicone stents in the management of airway problems. Ann Thorac Surg. 1989;47:371–378
  27. Carre P, Rosseau H, Lombart L, et al. Balloon dilatation and self-expanding metal Wallstent insertion for the management of bronchostenosis following lung transplantation. Chest. 1994;105:343–348
  28. Sonett JR, Keenan RJ, Ferson PF, Griffith BP, Landreneau RJ. Endobronchial management of benign, malignant, and lung transplantation airway stenosis. Ann Thorac Surg. 1995;59:1411–1422
  29. Susanato I, Peters JI, Levine SM, et al. Use of balloon-expandable metallic stents in the management of bronchial stenosis and bronchomalacia after lung transplantation. Chest. 1998;114:1330–1335
  30. Orons PD, Amesur NB, Dauber JH, et al. Balloon dilatation and endobronchial stent placement for bronchial strictures after lung transplantation. J Vasc Interv Radiol. 2000;11:89–99
  31. Mughal MM, Gildea TR, Murthy S, et al. Short term deployment of self-expanding metallic stents facilitates healing of bronchial dehiscence. Am J Respir Crit Care Med. 2005;172:768–771
  32. Colt HG, Janssen JP, Dumon JF, Noirclerc MJ. Endoscopic management of bronchial stenosis after double lung transplant. Chest. 1992;102:10–16
  33. Herrera JM, McNeil KD, Higgins RS, et al. Airway complications after lung transplantation: treatment and long-term outcome. Ann Thorac Surg. 2001;71:989–993
  34. Chhajed PN, Malouf MA, Tamm Michael, Glanville AR. Ultraflex stents for the management of airway complications in lung transplant recipients. Respirology. 2003;8:59–64
  35. Burns KE, Orons PD, Dauber JH, et al. Endobronchial metallic stent placement for airway complications after lung transplantation: longitudinal results. Ann Thorac Surg. 2002;74:1934–1941
  36. Chhajed PN, Malouf MA, Tamm M, Spratt P, Glanville AR. Interventional bronchoscopy for the management of airway complications following lung transplantation. Chest. 2001;120:1894–1899
  37. Saad CP, Ghamande SA, Minai OA, et al. The role of self-expandable metallic stents for the treatment of airway complications after lung transplantation. Transplantation. 2003;75:1532–1538
  38. Kapoor BS, May B, Panu N, Kowalik K, Hunter DW. Endobronchial stent placement for the management of airway complications after lung transplantation. J Vasc Interv Radiol. 2007;18:629–632
  39. Noirclerc MJ, Metras D, Vaillant A, et al. Bilateral bronchial anastomosis in double lung and heart-lung transplantations. Eur J Cardiothorac Surg. 1990;4:314–317
  40. Ladowski JS, Hardesty RL, Griffith BP. The pulmonary artery blood supply to the supracarinal trachea. J Heart Transplant. 1984;4:40–42
  41. Norgaard MA, Andersen CB, Petterson G. Airway epithelium of transplanted lungs with and without direct bronchial artery revascularization. Eur J Cardiothorac Surg. 1999;15:37–44
  42. Brichon PY, Blanc-Jouvan F, Rousseau H, et al. Endovascular stents for bronchial stenosis after lung transplantation. Transplant Proc. 1992;24:2656–2659
  43. Gershman AJ, Gildea TR, Mehta AC. Complication of metallic stent in lung transplant dehiscence. J Heart Lung Transplant. 2006;25:742–743
  44. Rousseau H, Dahan M, Lauque D, et al. Self-expandable prostheses in the tracheobronchial tree. Radiology. 1993;188:199–203
  45. Spatenka J, Khaghani A, Irving JD, et al. Gianturco self-expanding metallic stents in treatment of tracheobronchial stenosis after single lung and heart-lung transplantation. Eur J Cardiothorac Surg. 1991;5:648–665
  46. Dasgupta A, Dolmatch BL, Abi-Saleh WJ, Mathur PN, Metha AC. Self-expandable metallic stent insertion employing flexible bronchoscopy; preliminary results. Chest. 1998;114:106–109
  47. Miyazawa T, Yamakido M, Ikeda S, et al. Implantation of Ultraflex nitinol stents in malignant tracheobronchial stenosis. Chest. 2000;118:959–965
  48. Mehta AC, Dasgupta A. Airway stents. Clin Chest Med. 1999;20:139–151
  49. Hautmann H, Bauer M, Pfeifer KJ, Huber RM. Flexible bronchoscopy: a safe method for metal stent implantation in bronchial disease. Ann Thorac Surg. 2000;69:398–401
  50. Dineen KM, Jantz MA, Silvestri GA. Tracheobronchial stents. J Bronchol. 2002;9:127–137
  51. Dumon JF, Cavaliere S, Diaz-Jimenez JP, Vergnon JM. Seven-year experience with the Dumon prothesis. J Bronchol. 1996;3:6–10
  52. Martinez-Ballarin JI, Diaz-Jimenez JP, Castro MJ, Moya JA. Silicone stents in the management of benign tracheobronchial stenoses. Chest. 1996;109:626–629
  53. Jantz M, Silvestri GA. Silicone stents versus metal stents for management of benign tracheobronchial disease—pro: metal stents. J Bronchol. 2000;7:177–183

 Dr Jantz has received honorarium from Alveolus Inc and has served on the Alveolus Inc Medical Advisory Board since approximately year 2000. He has received $600 annually for this service from 2000 to 2006. This conflict of interest was reported to our local IRB for this project.

PII: S1053-2498(09)00236-8

doi: 10.1016/j.healun.2009.04.014

The Journal of Heart and Lung Transplantation
Volume 28, Issue 7 , Pages 683-688 , July 2009