Tracheal stent migration in malignant central airway obstruction – a case report and systematic review of literature

Manu Madan, Sreyas Sharma, Rohit Kumar, P. Ish, Rajnish Kaushik, Nitesh Gupta
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Abstract

Airway stents are critical in maintaining airway patency and managing Central Airway Obstruction (CAO) caused by malignant and benign conditions. Despite their effectiveness, complications such as stent migration are common. We report a case of a 25-year-old female with malignant CAO, which was initially managed with an ultra-flex Self-Expanding Metal Stent (SEMS) followed by stent migration and subsequently interlocking SEMS with Y stent deployment. This case report highlights the complexity of managing malignant CAO. More research is needed to establish optimal practices for preventing stent migration and improving patient outcomes. A systematic review of the literature on airway stent migration was also conducted, revealing an incidence of 5-17%, with higher rates in tracheal stents. Factors such as lesion characteristics and location significantly impact migration risk. This review discusses the advantages and challenges of SEMS compared to silicone stents, emphasizing the need for tailored approaches in stent placement and fixation to mitigate migration risks.
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恶性中央气道阻塞中的气管支架移位--病例报告和系统性文献综述
气道支架对于保持气道通畅和处理恶性和良性疾病引起的中央气道阻塞(CAO)至关重要。尽管支架效果显著,但支架移位等并发症也很常见。我们报告了一例 25 岁女性恶性 CAO 患者的病例,患者最初使用超柔性自膨胀金属支架(SEMS)进行治疗,但支架发生了移位,随后使用 Y 型支架联锁 SEMS。该病例报告凸显了恶性 CAO 治疗的复杂性。需要开展更多研究,以确定防止支架移位和改善患者预后的最佳方法。我们还对有关气道支架移位的文献进行了系统性回顾,发现其发生率为 5-17%,气管支架的发生率更高。病变特征和位置等因素对移位风险有重大影响。本综述讨论了 SEMS 与硅胶支架相比所具有的优势和面临的挑战,强调了在支架置入和固定方面采用定制方法以降低移位风险的必要性。
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