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Emergency management for congenital tracheal stenosis with endoluminal stenting in pediatric intensive care units

Xuan Xu1, Hui Ding2, Xicheng Liu3

  • 1Bayi Children's Hospital, Affiliated to Beijing Military General Hospital, Beijing, China.

Therapeutic Advances in Respiratory Disease
|April 30, 2016
PubMed

Insights

Self-expanding intraluminal stents effectively managed congenital tracheal stenosis (CTS) in infants, improving respiratory obstruction and enabling successful extubation. This airway stenting approach offers a valuable therapeutic option for infants with CTS.

Area of Science:

  • Pediatric Pulmonology
  • Interventional Bronchoscopy
  • Medical Device Technology

Background:

  • Congenital tracheal stenosis (CTS) presents a significant challenge in infant respiratory care.
  • Limited effective treatment options exist for severe CTS, often requiring complex surgical interventions.

Purpose of the Study:

  • To evaluate the safety and efficacy of self-expanding intraluminal stents for managing congenital tracheal stenosis in infants.
  • To share clinical experience and outcomes of airway stenting in a pediatric intensive care unit (PICU) setting.

Main Methods:

  • A retrospective study of 31 infants diagnosed with CTS between January 2010 and August 2012.
  • Bronchoscopic placement of self-expanding intraluminal stents in infants requiring respiratory support.
  • Assessment of immediate respiratory improvement, complications, stent functionality, and long-term outcomes.

Main Results:

  • All 31 infants experienced immediate improvement in respiratory obstruction post-stenting, facilitating weaning from mechanical ventilation and extubation.
  • No immediate stent-related airway complications occurred; granulation tissue in 9.7% of cases was managed successfully with cryotherapy.
  • Stents remained functional in 29 infants up to 24 months, with successful retrieval in seven cases and replacement needed in three.

Conclusions:

  • Airway stenting with self-expanding intraluminal stents is a viable and effective therapeutic option for infants with congenital tracheal stenosis.
  • This minimally invasive approach can significantly improve respiratory function and reduce the need for more invasive procedures in infants with CTS.
Abstract

Keywords:
flexible fiberoptic bronchoscopystentstracheal malaciatracheal stenosis

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