Anesthesia and airway management for removing pulmonary self-expanding metallic stents

Abstract The use of bronchoscopically placed self-expanding metallic stents (SEMS) and silastic stents in patients suffering from tracheobronchial stenosis or similar problems has proven to be an important clinical option. When complications occur, it may be necessary to remove the device. Removal o...

Full description

Saved in:
Bibliographic Details
Published in:Journal of clinical anesthesia 2009-11, Vol.21 (7), p.529-532
Main Authors: Doyle, D. John, MD, PhD, FRCPC, Abdelmalak, Basem, MD, Machuzak, Michael, MD, Gildea, Thomas R., MD
Format: Article
Language:English
Subjects:
Airway management
Anesthesia
Anesthesia & Perioperative Care
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biocompatible Materials
Biological and medical sciences
Device Removal - adverse effects
Device Removal - methods
Dimethylpolysiloxanes
Humans
Intubation
Intubation, Intratracheal
Lasers
Lung
Lung Transplantation
Medical sciences
Metallic stent
Metals
Migration
Mortality
Pain Medicine
Pulmonary arteries
Respiration, Artificial
Silastic stent
Stents
Tracheal Stenosis - complications
Tracheal Stenosis - surgery
Ventilation
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract The use of bronchoscopically placed self-expanding metallic stents (SEMS) and silastic stents in patients suffering from tracheobronchial stenosis or similar problems has proven to be an important clinical option. When complications occur, it may be necessary to remove the device. Removal of a SEMS is usually performed during general anesthesia with muscle relaxation and positive pressure ventilation, often using total intravenous anesthesia. Airway management depends on stent type and location. Intubating patients' tracheas with a tracheal stent requires special caution, as it risks damaging tissue and dislodging the stent distally. Potential complications with removal include tracheal disruption, retained stent pieces, mucosal tears, re-obstruction requiring new stent placement, the need for postoperative ventilation, pneumothorax, damage to the pulmonary artery, and death.
ISSN:0952-8180
1873-4529
DOI:10.1016/j.jclinane.2008.11.010