Endotracheal tube for relocating dislocated airway stent: a case report

Abstract

Background: Malignant central airway stenosis (CAO) is a life-threatening condition that may lead to emergency intubation and mechanical ventilation to manage severe respiratory failure. Airway stenting may facilitate extubation, and preserve stable airway for further cancer specific treatments. Herein, we reported an unconventional life-saving strategy using endotracheal tube (ETT) to relocate a displaced airway stent in a patient with critical CAO. Case Description: A 69-year-old man with severe malignant tracheal stenosis underwent emergent intubation. Airway stenting was placed and patient moved to Intensive Care Unit (ICU) with ETT in situ . Soon after extubation, the patient developed severe breathing difficulty due to stent dislocation. Under endoscopic view, a 7.5 mm ETT was placed within the stent; the balloon was inflated, and the tube with the stent was gently moved toward the carina, till the stent forced and covered the stenosis and its distal end was located above the carina. The balloon was then deflated, and the ETT was removed. Conclusions: Our method was not the first choice for relocating dislocating airway stent, but it should be considered as a life-saving treatment to perform in emergent situation when rigid bronchoscope and operating room were not readily available. The main lesson to be learned from this case was to not extubate a patient with a high-risk airway unless physicians are prepared to deal with the potential complications.