J Thorac Cardiovasc Surg 2006;131:254
© 2006 The American Association for Thoracic Surgery
Reply to the Editor
Itzhak Vinograd, MD
Department of Pediatric Surgery, DANA Children's Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
In my article I emphasized that the use of intratracheal stents in children is dangerous and carries the risk of severe complications.
With regard to the use of self-expandable metallic stents (SEMS), I completely agree that their use should be avoided. There are enough data in the literature to support this.
1
The SEMS in this study were made from nitinol, an alloy with a "shape memory effect." In animal studies, this stent, because of its unique biochemical property, could he fixed and removed easily, even in very small airways.
2
In children, their use was associated with an excessive granulation, and although the extraction proved to be easy and smooth, their application is currently suspended.
Currently available silicone or Dumoan stents have an external diameter that prevents their use in infants and small children.
The Montgomery and I-tubes could be an option in tracheal strictures, but they are not practical in bronchial or distal airway problems.
I would like to thank Mr Pramesh for his remarks.
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References
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- Giaissert H, Grillo H, Wright C, Donahue D, Wain J, Mathisen D. Complication of benign tracheobronchial strictures by self-expanding metal stents. J Thorac Cardiovasc Surg 2003;126:744-747.[Abstract/Free Full Text]
- Vinograd I, Klin B, Brosh T, Weinberg M, Flomenblit Y, Nevo Z. A new intratracheal stent made from nitinol, an alloy with "shape memory effect". J Thorac Cardiovasc Surg 1994;107:1255-1261.[Abstract/Free Full Text]
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