Bronchial stump fistula: treatment with covered, retrievable, expandable, hinged stents—preliminary clinical experience

Abstract

Purpose: To evaluate the preliminary clinical efficacy and retrievability of a covered, retrievable, metallic hinged stent in the treatment of bronchial stump fistula (BPF). Material and Methods: Between April 2003 and March 2005, eight patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types of covered, retrievable, metallic hinged stents. Type A stent was placed in six patients and type B in two under fluoroscopic guidance. The stent was removed with a retrieval set when BPF was healed or complications occurred. Results: Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BPF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed for 4–16 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BPF was achieved in seven (87.5%) of eight patients. Conclusion: Use of a covered, retrievable, expandable, metallic hinged stent is a simple, safe, and effective procedure for the closure of bronchial stump fistula. Retrieval of the stent seems feasible.