Preliminary experiences of self-expandable wire stent or "Wall stent" for bronchial obstruction

Fifteen Wall stents were placed in 11 patients under fluoroscopy through a fiberoptic bronchoscope to relieve malignant bronchial obstruction with pneumonia, atelectasis, and dyspnea. Eight patients had 11 stents. on the right main bronchus and bronchus intermedius, two patients had two stents on the left lower lobe bronchus, and the last patients had right and left main bronchus stent placement. Symptomatic improvement of dyspnea was dramatic but placement of the stent in the exact location was difficult. In three patients, a second stent was required because of improper location of the first stent. Five patients required minor adjustment of the location of the stent. It was successful only in three patients. Problems after stent placement included: two stent blockages by mucus plug that required frequent suction; three patients developed severe cough, and one of them coughed out the stent; and one tumor growth through the stent-developed in one patient. In our experience, the Wall stent can be safely placed to relieve malignant bronchial obstruction. Minor adjustment of its location is possible using a balloon. The covered orifices can be lasered without effecting the function of the stent. The non-covered Wall stent prevents immediate suffocation if placed in the wrong location.