Stent-in-Stent Technique for the Treatment of Proximal Bronchial Restenosis after Insertion of Metallic Stents: A Report of Two Cases

Abstract EN

Endoscopic treatment of a bronchial restenosis previously treated by insertion of a partially covered self-expandable metallic stent (SEMS) can be difficult.

Classically, after recanalization of the bronchus, the stent is removed and replaced by a more adapted one.

We report on two cases of proximal bronchial restenosis treated by insertion of an additional stent inside the lumen of the previously inserted stent using the stent-in-stent (SIS) technique.

The indications for the initial stent were malignancy in Patient 1 and posttransplant bronchial stenosis in Patient 2.

Restenosis occurred at the proximal end of the stent within months in both cases.

Stent removal and insertion of a new stent were considered, but this option was discarded because of an excessive risk of bronchial perforation and preference towards an alternative approach.

In both cases, a second customized SEMS was placed using the SIS technique after ablation of the proximal end stenosis of the stent by argon plasma coagulation and/or dilation with a balloon.

Recanalization of the bronchus was achieved in both cases without complications.

The SIS technique is a valuable alternative to removal of SEMS in case of proximal bronchial restenosis.