Subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia for patients with complex tracheobronchial stenosis: initial clinical experience.

PURPOSE We aimed to report our preliminary results of subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia for patients with complex lower tracheal-carinal-main bronchial complex stenosis. MATERIALS AND METHODS Seven consecutive patients with lower tracheal-carinal-main bronchial complex stenosis underwent Y-shaped stent insertion under local anesthesia. During the procedure, subcarinal ventilation was performed using a 4 F angiographic catheter, and stent insertion was performed under the protection of ventilation. Data on technical success, clinical outcome, and follow-up were collected and analyzed. RESULTS Subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia was technically successful in all patients without any major procedure-related complications. Seven stents were inserted in seven patients. Respiratory function improved in all patients, with the Hugh-Jones classification of respiratory status improving from grade IV-V before stenting to grade I-II after stenting. During the follow-up, one patient experienced re-stenosis of the stent. Average survival time was 185.7 days (range, 96-285 days) after the stenting procedure. CONCLUSION Subcarinal ventilation-assisted Y-shaped stent insertion under local anesthesia can be an effective, simple, and safe method for lower tracheal-carinal-main bronchial complex stenosis.