Use of the Palmaz Stent in the Treatment of Severe Tracheomalacia

To present our experience with the use of the Palmaz stent in treating cases of severe, life-threatening tracheomalacia, and to report our experience with the use of tracheal stents in patients who have concomitant tracheotomies, we performed a retrospective study in a tertiary-care children's...

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Bibliographic Details
Published in:Annals of otology, rhinology & laryngology rhinology & laryngology, 2004-08, Vol.113 (8), p.641-647
Main Authors: Geller, Kenneth A., Koempel, Jeffrey A., Wells, Winfield J., St John, Maie A. R.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Child, Preschool
Fatal Outcome
Female
Humans
Infant
Infant, Newborn
Male
Medical sciences
Otorhinolaryngology. Stomatology
Pneumology
Respiratory system : syndromes and miscellaneous diseases
Retrospective Studies
Stents
Trachea - abnormalities
Tracheal Diseases - therapy
Tracheal Stenosis - therapy
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Summary:To present our experience with the use of the Palmaz stent in treating cases of severe, life-threatening tracheomalacia, and to report our experience with the use of tracheal stents in patients who have concomitant tracheotomies, we performed a retrospective study in a tertiary-care children's hospital. Nine patients with multiple congenital anomalies including severe tracheomalacia required placement of a Palmaz stent to prolong life. The congenital anomalies included congenital heart disease, congenital lung disease, meningomyelocele, laryngotracheoesophageal cleft, and tracheoesophageal fistula. Three of the patients had concomitant tracheotomies. Each patient had placement of one or more Palmaz stents in the trachea and/or bronchus. Four patients died, and 5 patients are still alive. Three of the 4 patients who died had concomitant tracheotomies and died of complications associated with significant tracheal hemorrhage. The fourth died of pulmonary complications following repeated episodes of pneumonia. None of the 5 patients who are still alive had a concomitant tracheotomy. The Palmaz stent is a useful tool for treating life-threatening tracheomalacia as a final resort in this difficult patient population; however, the use of these stents may lead to subsequent hemorrhage and death, especially in patients with tracheotomies, so their use must be carefully considered.
ISSN:0003-4894
1943-572X
DOI:10.1177/000348940411300808