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Outcome of long-term complications after permanent metallic left bronchial stenting in children

Paola Serio1, Raffaella Nenna2, Marco Di Maurizio3

  • 1Department of Paediatric Anesthesia and Intensive Care, Meyer Children Hospital, Florence, Italy.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|November 11, 2017
PubMed

Insights

Metallic stents in pediatric left mainstem bronchus can cause critical long-term complications like ovalization and breakage. Careful patient selection and monitoring are crucial for successful outcomes in pediatric airway stenting.

Area of Science:

  • Pediatric Pulmonology
  • Interventional Pulmonology
  • Biomaterials in Medicine

Background:

  • Metallic balloon-expandable stents are used in pediatric airway management.
  • Long-term complications in pediatric patients after stenting are not fully understood.

Purpose of the Study:

  • To describe the treatment and outcomes of children with critical long-term complications after metallic stenting of the left mainstem bronchus.
  • To identify mechanisms of stent-related complications in growing children.

Main Methods:

  • Retrospective case series of 7 children treated for complications after metallic left mainstem bronchus stenting.
  • Follow-up included serial bronchoscopies and chest computed tomographic angiography.
  • Surgical interventions and secondary stenting were performed as needed.

Main Results:

  • All 7 children experienced recurrent stent ovalization, with 3 cases of stent breakage and 1 of erosion.
  • Complications included peribronchial fibrosis, mediastinal rotation, and stent displacement.
  • Six children underwent surgery, and 3 required additional nitinol stents; 5 have permanent, patent stents after a median 10.5-year follow-up.

Conclusions:

  • Initial satisfactory anatomical results do not guarantee long-term success for metallic stents in pediatric left mainstem bronchus.
  • Growth-related mechanisms can lead to critical stent complications.
  • Permanent metallic stents require careful consideration and should be reserved for select pediatric patients.
Abstract

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