Marked Respiratory Improvement After ECMO-Supported Exchange From Metallic to Silicone Stent in Tracheobronchial...

A woman in her mid-50s with tracheobronchial stenosis due to tuberculosis underwent covered metallic stent insertion via flexible bronchoscopy at a referral hospital. Subsequently, an additional silicone Y stent was inserted via rigid bronchoscopy to relieve stenosis distal to the metallic stent. Although her respiratory condition improved markedly after stenting, long-term complications related to metallic stents such as stent fracture and restenosis were anticipated. Seven months after the first metallic stent insertion, both stents were removed and replaced with silicone stents in accordance with guidelines for the management of benign tracheobronchial stenosis, under veno-venous extracorporeal membrane oxygenation (ECMO) support without systemic anticoagulation. The procedure was completed successfully without intraoperative complications. Following the insertion of two silicone stents, her respiratory symptoms and pulmonary function improved as the silicone stents seemed to have provided her airway with more stable support. We report a case of successful metallic-to-silicone stent replacement under ECMO support in a patient with severe benign airway stenosis.