Bronchial stenting in infants with severe bronchomalacia: Technique and outcomes

Area of Science:

• Pediatric Pulmonology
• Interventional Pulmonology
• Medical Device Innovation

Background:

• Infant bronchomalacia poses significant risks, often necessitating prolonged mechanical ventilation.
• Severe cases of infant bronchomalacia present treatment challenges, with limited effective therapeutic options.
• This study addresses the unmet need for effective interventions in refractory infant bronchomalacia.

Purpose of the Study:

• To evaluate the efficacy and safety of using balloon-expandable bare metal stents for treating infant bronchomalacia.
• To report the first clinical application of coronary bare metal stents in pediatric bronchial stenting.
• To present a novel treatment strategy for severe, treatment-refractory infant bronchomalacia.

Main Methods:

• Three infants with severe, refractory bronchomalacia underwent bronchial stenting between February 2019 and December 2020.
• Diagnosis was confirmed using Computed Tomography (CT) angiography, followed by comprehensive airway evaluation.
• Patients who failed conservative management were considered for rescue bronchial stenting using coronary bare metal stents.

Main Results:

• Bronchial stenting with coronary bare metal stents was technically successful and easy to deploy.
• No instances of stent embolization, migration, restenosis, or erosion were observed.
• One stent was successfully removed after 12 months, maintaining bronchial patency without complications.

Conclusions:

• Bronchial stenting with balloon-expandable bare metal stents is an effective treatment for severe infant bronchomalacia.
• This technique offers a safe and reliable option for managing refractory cases, with good stent performance.
• The procedure demonstrated favorable outcomes, including successful stent removal in one case.