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Angulated Stents—A Novel Stent Improvisation to Manage Difficult Post-tuberculosis Bronchial Stenosis

Tay, Chee Kiang*; Jeong, Byeong-Ho; Kim, Hojoong

doi: 10.1097/MAT.0000000000000692
Pulmonary

Post-tuberculosis bronchostenosis (PTBS), a complication of endobronchial tuberculosis is currently treated by bronchial stenting. However, in cases of angulated bronchial stenoses, difficulty is often encountered in stent insertion and maintenance, resulting in stent migration, granulation tissue overgrowth, and restenosis. To accommodate the angulated alignment of the stenosis, we devised an “angulated stent”—a novel improvisation of the conventional stent via splicing and suturing to achieve a resultant angulated shape. A retrospective review was undertaken to evaluate the performance of this stent. Among 283 PTBS patients who underwent interventional bronchoscopy at our center from 2004 to 2014, 21 were treated with at least one angulated stent. Clinical outcomes, including the stenting duration were investigated. After a median follow-up of 26 months, stent removal was successful in 7 (33.3%) out of 21 patients. In patients managed with angulated stents, the median duration to stent change or eventual removal was longer than those treated with straight tube stents (392 days vs. 86 days; p < 0.05). Angulated stents are a feasible treatment option in patients with angulated PTBS by reducing complications and prolonging the stent-changing interval.

From the *Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore 169608, Singapore

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.

Submitted for consideration March 2017; accepted for publication in revised form September 2017.

Disclosure: The authors have no conflicts of interest to report.

Correspondence: Hojoong Kim, MD, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. Email: hjk3425@skku.edu.

Copyright © 2018 by the American Society for Artificial Internal Organs