Trials of Airway-stent Removal in Patients with Airway Stenosis

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Background: Studies on airway-stent removal, a dangerous procedure that involves a difficult decision-making, are scarce. We aimed to use our experience with trials of removal on airway stenosis to elucidate predictors of a successful airway-stent removal.

Materials and Methods: We retrospectively analyzed clinical data of 11 patients with central airway stenosis or obstruction who underwent trial of airway-stent removal at Toho University Omori Medical Center between 2002 and 2021.

Results: A total of nine patients had benign airway stenosis, of whom four and five had successful and failed removal, respectively. Two patients had stenosis caused by a malignant disease, and both underwent successful removal. All patients with postoperative stenosis had failed removal, although no significant difference was observed between patients with successful and failed removal. Tracheal and bronchial rings at the stenotic portion had a significant difference between patients with successful and failed removal. All patients with tracheal and bronchial rings had successful removal, although one patient without tracheal and bronchial rings had successful removal. All patients that lacked space around the stent, stent migration, and tracheal and bronchial rings had failed removal attempts. A significant difference was observed in the presence of these factors between patients with successful and failed removal.

Conclusions: Patients with malignant airway stenosis may undergo successful removal of airway stents, whereas patients with benign airway stenosis may not always have successful removal. In patients with airway stenosis, space around the stent, stent migration, and tracheal and bronchial rings may be predictors of successful airway-stent removal.