{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:55:07Z","timestamp":1787028907603,"version":"build-2736575974"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T00:00:00Z","timestamp":1595376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The use of metallic stents in benign TBS is controversial. Here, we report the clinical outcomes of patients who developed complications due to self-expandable metallic stent (SEMS) insertion for benign TBS. Materials and Methods: Our institution, which is the largest and most active referral hospital for airway stenosis in South Korea, only uses silicone stents. We conducted a retrospective review of 20 patients referred after the insertion of SEMS for benign TBS from 2006 to 2015. Results: All 20 patients underwent rigid bronchoscopy for SEMS removal due to airway obstruction from granulation tissue overgrowth. All but one (95%) experienced successful removal of the SEMS. During a median follow-up period of 40 months, a median of seven rigid bronchoscopies per patient was needed to maintain airway patency. Three (15%) patients suffered acute complications during SEMS removal (bleeding (10%) and fistula (5%)). All patients suffered chronic complications (granulation tissue (80%), stent migration (58%), mucostasis (55%), and restenosis (43%)). Eventually, 15 patients (75%) needed airway prostheses (silicone stent (75%) and tracheostomy (25%)). Conclusion: Our findings indicate that SEMS should be avoided until positive results are consistently reported by high-quality studies in patients with benign TBS.<\/jats:p>","DOI":"10.3390\/medicina56080367","type":"journal-article","created":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T10:14:06Z","timestamp":1595499246000},"page":"367","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Clinical Outcomes of Complications Following Self-Expandable Metallic Stent Insertion for Benign Tracheobronchial Stenosis"],"prefix":"10.3390","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3124-1718","authenticated-orcid":false,"given":"Byeong-Ho","family":"Jeong","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Ng","sequence":"additional","affiliation":[{"name":"Division of Respiratory and Critical Care Medicine, University Medicine Cluster, National University Hospital, Singapore 119074, Singapore"},{"name":"Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suk Hyeon","family":"Jeong","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9207-0433","authenticated-orcid":false,"given":"Hojoong","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.ejcts.2008.10.041","article-title":"Interventional endoscopy in the management of benign tracheal stenoses: Definitive treatment at long-term follow-up","volume":"35","author":"Galluccio","year":"2009","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S792","DOI":"10.1016\/j.athoracsur.2007.11.051","article-title":"Airway stents","volume":"85","author":"Chin","year":"2008","journal-title":"Ann. Thorac. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1378\/chest.97.2.328","article-title":"A dedicated tracheobronchial stent","volume":"97","author":"Dumon","year":"1990","journal-title":"Chest"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1159\/000205396","article-title":"On-site customization of silicone stents: Towards optimal palliation of complex airway conditions","volume":"77","author":"Breen","year":"2009","journal-title":"Respiration"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1097\/MAT.0000000000000692","article-title":"Angulated Stents-A Novel Stent Improvisation to Manage Difficult Post-tuberculosis Bronchial Stenosis","volume":"64","author":"Tay","year":"2018","journal-title":"ASAIO J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1378\/chest.109.3.626","article-title":"Silicone stents in the management of benign tracheobronchial stenoses. Tolerance and early results in 63 patients","volume":"109","author":"Castro","year":"1996","journal-title":"Chest"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1183\/09031936.00020906","article-title":"Use of silicone stents for the management of post-tuberculosis tracheobronchial stenosis","volume":"28","author":"Ryu","year":"2006","journal-title":"Eur. Respir. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1111\/resp.12925","article-title":"Clinical significance of differentiating post-intubation and post-tracheostomy tracheal stenosis","volume":"22","author":"Shin","year":"2017","journal-title":"Respirology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1586\/17476348.2014.880055","article-title":"The use of self-expandable metallic stents in the airways in the adult population","volume":"8","author":"Dutau","year":"2014","journal-title":"Expert Rev. Respir. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1111\/j.1440-1843.2009.01490.x","article-title":"Changing patterns in interventional bronchoscopy","volume":"14","author":"Zias","year":"2009","journal-title":"Respirology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1016\/S0022-5223(94)70046-X","article-title":"A New Intratracheal Stent Made from Nitinol, an Alloy with Shape-Memory Effect","volume":"107","author":"Vinograd","year":"1994","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1378\/chest.114.1.106","article-title":"Self-expandable metallic airway stent insertion employing flexible bronchoscopy: Preliminary results","volume":"114","author":"Dasgupta","year":"1998","journal-title":"Chest"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1378\/chest.09-2682","article-title":"Outcomes, health-care resources use, and costs of endoscopic removal of metallic airway stents","volume":"138","author":"Alazemi","year":"2010","journal-title":"Chest"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/S0272-5231(21)01001-7","article-title":"Airway stents. Present and future","volume":"16","author":"Colt","year":"1995","journal-title":"Clin. Chest Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1111\/j.1440-1843.1998.tb00126.x","article-title":"Stenting therapy for stenosing airway disease","volume":"3","author":"Kim","year":"1998","journal-title":"Respirology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1111\/j.1440-1843.2006.00955.x","article-title":"Comparison of natural and Dumon airway stents for the management of benign tracheobronchial stenoses","volume":"11","author":"Ryu","year":"2006","journal-title":"Respirology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"431","DOI":"10.4046\/trd.2002.53.4.431","article-title":"The Usefulness and Safety of Natural Stent in a Canine Model of Tracheal Stenosis","volume":"53","author":"Kim","year":"2002","journal-title":"Tuberc. Respir. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1097\/00000542-197810000-00003","article-title":"ASA physical status classifications: A study of consistency of ratings","volume":"49","author":"Owens","year":"1978","journal-title":"Anesthesiology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1177\/000348949410300410","article-title":"Proposed grading system for subglottic stenosis based on endotracheal tube sizes","volume":"103","author":"Myer","year":"1994","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"880","DOI":"10.2214\/AJR.12.10425","article-title":"Metallic stent placement for the management of tracheal carina strictures and fistulas: Technical and clinical outcomes","volume":"202","author":"Kim","year":"2014","journal-title":"Am. J. Roentgenol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"31","DOI":"10.4046\/trd.2015.78.1.31","article-title":"Serious Complications after Self-expandable Metallic Stent Insertion in a Patient with Malignant Lymphoma","volume":"78","author":"Cho","year":"2015","journal-title":"Tuberc. Respir. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2599","DOI":"10.21037\/jtd.2017.06.88","article-title":"Respiratory support with venovenous extracorporeal membrane oxygenation during stent placement for the palliation of critical airway obstruction: Case series analysis","volume":"9","author":"Park","year":"2017","journal-title":"J. Thorac. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/S0022-5223(03)00361-1","article-title":"Complication of benign tracheobronchial strictures by self-expanding metal stents","volume":"126","author":"Gaissert","year":"2003","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2106","DOI":"10.1378\/chest.127.6.2106","article-title":"Endoscopic removal of metallic airway stents","volume":"127","author":"Lunn","year":"2005","journal-title":"Chest"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1097\/LBR.0b013e318053d445","article-title":"Complications of Metal Stent Therapy in Benign Airway Obstruction","volume":"14","author":"Swanson","year":"2007","journal-title":"J. Bronchol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/LBR.0b013e318206f0a4","article-title":"Endoscopic removal of metallic airway stents","volume":"18","author":"Wang","year":"2011","journal-title":"J. Bronchol. Interv. Pulmonol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1111\/j.1440-1843.2011.01998.x","article-title":"Factors predicting outcome following airway stenting for post-tuberculosis tracheobronchial stenosis","volume":"16","author":"Lim","year":"2011","journal-title":"Respirology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/1749-8090-6-46","article-title":"An outcome analysis of self-expandable metallic stents in central airway obstruction: A cohort study","volume":"6","author":"Chung","year":"2011","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1007\/s00270-013-0602-6","article-title":"Metallic stents for tracheobronchial pathology treatment","volume":"36","author":"Serrano","year":"2013","journal-title":"Cardiovasc. Intervent. Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1159\/000203364","article-title":"Performance of Fully Covered Self-Expanding Metallic Stents in Benign Airway Strictures","volume":"77","author":"Dooms","year":"2009","journal-title":"Respiration"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1159\/000472155","article-title":"Safety and Efficacy of a Fully Covered Self-Expandable Metallic Stent in Benign Airway Stenosis","volume":"93","author":"Fortin","year":"2017","journal-title":"Respiration"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Xiong, X.F., Xu, L., Fan, L.L., Cheng, D.Y., and Zheng, B.X. (2019). Long-term follow-up of self-expandable metallic stents in benign tracheobronchial stenosis: A retrospective study. BMC Pulm. Med., 19.","DOI":"10.1186\/s12890-019-0793-y"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/8\/367\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:50:54Z","timestamp":1760176254000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/8\/367"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,22]]},"references-count":32,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020,8]]}},"alternative-id":["medicina56080367"],"URL":"https:\/\/doi.org\/10.3390\/medicina56080367","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,22]]}}}