Clinical Evaluation of Fluoroscopically Guided Removal of Tracheal Tube Metallic Stents

Abstract Background: The risk of complications associated with stent placement is high in patients with long-term airway stent placement. Our aim is to evaluate the removal of tracheal tube metallic stents under fluoroscopic guidance.Methods: We retrospectively reviewed 45 cases (31 males and 14 females; age, 12–71 years) of tracheal metallic stent removal performed at our center between January 2014 and December 2018. Covered stents were applied in 36 cases, and uncovered stents were applied in 9 cases. In the covered stent group, 15 patients presented with granulation tissue at both ends; 3 cases, with stent fracture; and 2, with stent intolerance. In the uncovered stents group, all patients presented with granulation tissue formation; 2 patients, with stent fracture; and 1 patient, with stent intolerance. Results: A total of 41 (91.1%) stents were successfully removed (34 [94.4%] in the covered stent group and 7 [77.8%] in the uncovered stent group). The average duration of stent placement was 3.2 ± 0.7 and 2.5 ± 1.2 months in the covered stent group and uncovered stent group, respectively. With regard to the complications, hemoptysis occurred in 4 cases (average blood volume lost, 100 ml), tracheal mucosa tear occurred in 5 cases, tracheal collapse requiring emergency airway stent placement occurred in 1 case, and tracheal rupture requiring emergency surgical suture occurred in 1 case. No procedure-related deaths occurred in either group. Conclusions: Fluoroscopically guided removal of tracheal tube metallic stents is safe, and may reduce the complications associated with long-term stent placement.