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J Thorac Cardiovasc Surg 2005;130:223-224
© 2005 The American Association for Thoracic Surgery

Brief Communication

Multiple tracheal stenting or perseverare diabolicum est

Matthias Altmayer, MD a , Christian Biancosino, MD a , Jochen Strauss, MD b , Paolo Macchiarini, MD, PhD a , *

a Department of Thoracic and Vascular Surgery, Heidehaus Hospital, Hannover Medical School, Hannover, Germany
b Departments of Anaesthesiology and Intensive Care, Helios Klinikum Berlin-Buch, Charité, Berlin, Germany.

Received for publication October 19, 2004; revisions received November 17, 2004; accepted for publication December 8, 2004.

* Address for reprints: Paolo Macchiarini, MD, PhD, Department of General Thoracic Surgery, Hospital Clinic, University of Barcelona c/Villarroel 170, E-08036 Spain (Email: pmacchiarini@compuserve.com).

The first 20% of the full text of this article appears below.

Most would agree that a flexible application of a variety of endoscopic techniques, even combined in the same patient, provide the best chance for a successful outcome for benign but unresectable airway obstruction.1Go However, concern has been raised concerning the enthusiastic attitude toward endoluminal stents and their preference over surgical repair in the absence of true contraindications.2Go A life-threatening clinical scenario of this attitude is presented here.

Clinical Summary

A 38-year-old man was referred mechanically ventilated and nasotracheally intubated to our department for ultimate evaluation. His past history was remarkable for a diphtherial tracheomalacia at the age of 2 years, requiring a cervical tracheotomy and long-term intubation; a postintubation subglottic stenosis managed with a Rethi tracheoplasty3Go in 2000 complicated with a dislocation of the transferred cartilage, requiring endoscopic removal; and a subglottic restenosis treated with the endoluminal placement of a flexible metal stent (Strecker, Boston Scientific Corp, Natick, Mass) in June 2002. Three months later, the patient presented again with severe dyspnea. Because bronchoscopy showed . . . [Full Text of this Article]






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Copyright © 2005 by The American Association for Thoracic Surgery.