CardioVascular and Interventional Radiology

, Volume 27, Issue 4, pp 339–343 | Cite as

Treatment of Benign and Malignant Tracheobronchial Obstruction with Metal Wire Stents: Experience with a Balloon-Expandable and a Self-Expandable Stent Type

  • Johannes RiegerEmail author
  • Hubert Hautmann
  • Ulrich Linsenmaier
  • Cristoph Weber
  • Markus Treitl
  • RÅ«dolf Maria Huber
  • Klaus-Jürgen Pfeifer


Over the last few years various types of metal wire stents have been increasingly employed in the treatment of both malignant and benign tracheobronchial obstruction. To date, however, few studies have investigated the in vivo properties of different stent types. We implanted 26 balloon-expandable tantalum Strecker stents (18 patients) and 18 self-expandable Wallstents (16 patients) into the tracheobronchial system of 30 patients with combined stenting in 4 patients. Mean age was 51 years (range: 0.5–79 years). Malignant disease was present in 23 patients, benign disease in seven patients. Both patients and individual stents were monitored clinically and radiographically. The probability of stents remaining within the tracheobronchial system, and of their remaining undislocated and uncompressed was calculated using Kaplan-Meier analysis for both stent types. Average stent follow-up time was 112 days until explantation and 115 days until patients’ death or discharge. Kaplan-Meier analysis revealed a higher probability for the Wallstent to remain within the tracheobronchial system. Dislocation and compression occurred more rarely. Explantation, however, if desired, was more difficult compared to the Strecker stent. The Wallstent also led to the formation of granulation tissue, especially at the proximal stent end, frequently requiring reintervention. Both stent types proved to be effective therapeutic options in the management of obstructive tracheobronchial disease. The mechanical properties of the Strecker stent seem to be less favorable compared to the Wallstent but removal is easy. For benign disease, however, the Wallstent reveals limitations due to significant side effects.

Stents Intervention Tracheobronchial tree Stenosis 


  1. 1.
    Wanamaker, JR, Eliachar, I 1995An overview of treatment options for lower airway obstructionOtolaryngol Clin North Am28751770PubMedGoogle Scholar
  2. 2.
    Becker, HD 1994Current possibilities and limits of bronchoscopic tracheobronchial stentingPneumologie48:(3182190Google Scholar
  3. 3.
    de Souza, AC, Keal, R, Hudson, NM 1994Use of expandable wire stents for malignant airway obstructionAnn Thorac Surg5715731577AUTHOR: list all authorsPubMedGoogle Scholar
  4. 4.
    Nomori, H, Kobayashi, R, Kodera, K 1993Indications for an expandable metallic stent for tracheobronchial stenosisAnn Thorac Surg5613241328PubMedGoogle Scholar
  5. 5.
    Shah, R, Sabanathan, S, Lowe, RA 1996Stenting in malignant obstruction of superior vena cavaJ Thorac Cardiovasc Surg112335340PubMedGoogle Scholar
  6. 6.
    Dasgupta, A, Dolmatch, BL, Abi-Saleh, WJ 1998Self-expandable metallic airway stent insertion employing flexible bronchoscopy: preliminary resultsChest114106109PubMedGoogle Scholar
  7. 7.
    Eisner, MD, Gordon, RL, Webb, WR 1999Pulmonary function improves after expandable metal stent placement for benign airway obstructionChest11510061011CrossRefPubMedGoogle Scholar
  8. 8.
    Bolot, G, Poupart, M, Pignat, JC 1998Self-expanding metal stents for the management of bronchial stenosis and bronchomalacia after lung transplantationLaryngoscope10812301233CrossRefPubMedGoogle Scholar
  9. 9.
    Ross, BB, Gramiak, R, Rahn, H 1955Physical dynamics of the cough mechanismJ Appl Physiol8264268PubMedGoogle Scholar
  10. 10.
    Hauck, RW, Lembeck, RM, Emslander, HP 1997Implantation of Accuflex and Strecker stents in malignant bronchial stenoses by flexible bronchoscopyChest112134144PubMedGoogle Scholar
  11. 11.
    Hautmann, H, Huber, RM 1996Stent flexibility: an essential feature in the treatment of dynamic airway collapseEur Respir J9609611CrossRefPubMedGoogle Scholar
  12. 12.
    Hautmann, H, Rieger, J, Huber, RM 1999Elastic deformation properties of implanted endobronchial wire stents in benign and malignant bronchial disease: a radiographic in vivo evaluationCardiovasc Intervent Radiol22103108CrossRefPubMedGoogle Scholar
  13. 13.
    Strecker, EP, Liermann, D, Barth, KH 1990Expandable tubular stents for treatment of arterial occlusive direases: experimental and clinical resultsRadiology17597102PubMedGoogle Scholar
  14. 14.
    Freitag, L, Eicker, K, Donovan, TJ, Dimov, D 1995Mechanical properties of airway stentsJ Bronchology.270278Google Scholar
  15. 15.
    Hramiec, JE, Haasler, GB 1997Tracheal wire stent complications in malacia: implications of position and designAnn Thorac Surg63209212CrossRefPubMedGoogle Scholar
  16. 16.
    Maynar, M, Lopez, L, Gorriz, E 1993Massive brachiocephalic artery bleeding due to a Gianturco tracheal stentJ Vasc Interv Radiol4289291PubMedGoogle Scholar
  17. 17.
    Smith, PG, Murphy, DF 1991An evaluation of one method of ventilation for laser therapy to the tracheobronchial treeAnaesth Intensive Care19225227PubMedGoogle Scholar
  18. 18.
    Stanopoulos, IT, Beamis, JF J, Martinez, FJ 1993Laser bronchoscopy in respiratory failure from malignant airway obstructionCrit Care Med21386391PubMedGoogle Scholar
  19. 19.
    Tsang, V, Williams, AM, Goldstraw, P 1992Sequential silastic and expandable metal stenting for tracheobronchial stricturesAnn Thorac Surg53856860PubMedGoogle Scholar
  20. 20.
    Pierce, RJ 1991Lasers, brachytherapy and stents—keeping the airways openRespir Med85263265PubMedGoogle Scholar
  21. 21.
    Susanto, I, Peters, JI, Levine, SM 1998Use of balloon-expandable metallic stents in the management of bronchial stenosis and bronchomalacia after lung transplantationChest11413301335PubMedGoogle Scholar
  22. 22.
    Rafanan, AL, Mehta, AC 2000Stenting of the tracheobronchial treeRadiol Clin North Am38(2395408Google Scholar

Copyright information

© Springer-Verlag New York, Inc. 2004

Authors and Affiliations

  • Johannes Rieger
    • 1
    Email author
  • Hubert Hautmann
    • 2
  • Ulrich Linsenmaier
    • 1
  • Cristoph Weber
    • 1
  • Markus Treitl
    • 1
  • RÅ«dolf Maria Huber
    • 2
  • Klaus-Jürgen Pfeifer
    • 1
  1. 1.Department of Clinical RadiologyUniversity Hospitals of the Ludwig-Maximilians-UniversityMünchen
  2. 2.Department of PneumologyUniversity Hospitals of the Ludwig-Maximilians-UniversityMünchen

Personalised recommendations