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Case Reports
. 2013 Apr;8(2):116-20.
doi: 10.4103/1817-1737.109830.

Broncho-vascular fistulas from self-expanding metallic stents: A retrospective case review

Chirag Choudhary  1 , Debabrata Bandyopadhyay, Reyadh Salman, Thomas Gildea, Atul Mehta
Affiliations
Case Reports

Broncho-vascular fistulas from self-expanding metallic stents: A retrospective case review

Chirag Choudhary et al. Ann Thorac Med. 2013 Apr.

Abstract

To highlight a potentially fatal complication of broncho-vascular fistula arising from the self expanding metallic stent (SEMS) placement. We retrospectively analyzed five patients with benign and malignant airway diseases, who developed tracheo/broncho-vascular fistulas following SEMS placement in our tertiary care setting. All patients received either Wallstent or Ultraflex(®) stent (Boston Scientific, Natick, MA) between 1999 and 2007. All patients had received adjunct therapy such as balloon bronchoplasty, laser therapy or electrocautery. Most patients presented with massive hemoptysis. A total of 483 SEMS were placed during this period. SEMS placement can be complicated by Broncho-vascular fistula formation. True incidence and precise time interval between the insertion of stent and onset of this complication is unknown. Additional therapeutic modalities to maintain stent patency may enhance the risk of fistula formation. SEMS should only be used in a select sub-group of patients, after exhaustive evaluation of other treatment options. These cases provide evidence that broncho-vascular fistulas can develop at any time following SEMS placement, suggesting the need for a more cautious approach, especially while using them for a long term management. In benign airway disease, the stent should be removed as soon as healing has taken place.

Keywords: Benign airways disease; bronchial stents; complications; endobronchial growth; ultraflex; wall stent.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Anastomotic dehiscence – Right main stem bronchus (arrows)
Figure 2
Figure 2
SEMS abutting the left pulmonary artery
Figure 3
Figure 3
Coronal view showing loss of tissue plane between SEMS and pulmonary artery
Figure 4
Figure 4
SEMS in right bronchus abutting right pulmonary artery
Figure 5
Figure 5
Tracheo‑mediastinal fistula seen between SEMS and aorta (arrows)
See this image and copyright information in PMC

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