Implantation of a self-expandable metallic inverted Y-stent to treat tracheobronchial stenosis in the carinal region: initial clinical experience.

Introduction Tracheobronchial stenoses or fistulas caused by benign or malignant diseases are life-threatening and present as respiratory distress symptoms.Airway stent insertion is an effective and widely used method to manage this condition. When the stenoses or the fistulas exist in the lower trachea,main carina, and main-stem bronchi, the insertion of one hinged stent or angled stent, or two straight stents, does not provide complete lesion coverage. Thus, the placement of a Y-stent in these patients is often required for successful palliation. The most commonly used Y-stent in the carinal region is the silicone Dumon stent. Hauck et al. described the use of two self-expanding nitinol stents to create a Y-configuration, which requires the bronchoscopic creation of an opening in one stent using a laser to allow the second stent to be placed. The use of a custommade, selfexpanding, metallic, inverted Y-stent, which is inserted under fluoroscopic guidance, has not been previously reported. During 2006, the authors designed a system (Micro-Tech, Nanjing, China) specialized for delivery and deployment of the self-expandable, metallic, inverted Y-stent in the carinal area. The purpose of this study was to evaluate the initial clinical feasibility and efficacy of an expandable metallic inverted Y-stent to treat complex tracheobronchial stenoses in the carinal region.