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Clinical Image
Triple stent placement for tracheoesophageal fistula closure
Colocación de triple prótesis para cierre de fístula traqueoesofágica
Blanca de Vega Sáncheza,b,
Corresponding author
blancadevegasanchez@gmail.com

Corresponding author.
, Carlos Disdier Vicentea,c, Manuel Pérez-Mirandad
a Unidad de Broncoscopias y Técnicas Pleurales, Servicio de Neumología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
b Grupo Emergente SEPAR de Broncoscopia y Neumología Intervencionista (GEBRYN)
c Centro de Investigación en Red Enfermedades Respiratorias (CIBERES)
d Servicio de Digestivo, Hospital Universitario Río Hortega, Valladolid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 54-year-old male diagnosed in November 2018 with esophageal cancer with mediastinal involvement and histology consistent with epidermoid carcinoma&#46; The mass caused esophageal stenosis&#44; manifested clinically as difficulty swallowing liquids&#44; excessive salivation&#44; and aspiration pneumonia in the right lower lobe&#46; A 32&#8239;&#215;&#8239;210&#8239;mm self-expanding metal esophageal stent &#40;SEMS&#41; was placed &#40;subsequently replaced due to intolerance with a 23&#8239;&#215;&#8239;105&#8239;mm Wallflex&#174; Fully Covered SEMS&#44; Boston Scientific&#174;&#41; and an 35&#8239;mm Amplatzer&#174; atrial septal defect occluder &#40;Abbott&#174;&#41; was inserted due to loss of integrity of the distal third of the tracheal posterior wall&#46; Given the lack of resolution of the clinical picture&#44; flexible bronchoscopy was performed&#44; which confirmed the presence of a large tracheal defect&#44; with visualization of both previously implanted devices &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; An Aerstent&#174; tracheal Y-stent with partial polyurethane coating &#40;Leufen&#174;&#41; measuring 40&#8239;&#215;&#8239;20&#8239;&#215;&#8239;30&#8239;mm was implanted using fluoroscopy-guided rigid bronchoscopy without complications&#46; Additional intra- and post-operative imaging tests showed correct positioning of the 3 devices &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#44; <span class="elsevierStyleSmallCaps">C</span>&#44; and D&#41;&#44; while the patient&#8217;s clinical situation improved&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Fistulas or communications between the airway and the esophagus are an uncommon complication of esophageal and pulmonary malignancies&#44; and require a sequential and individualized endoscopic approach and the use of several devices aimed at improving patients&#8217; symptoms<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a>&#46;</p></span>"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; de Vega S&#225;nchez B&#44; Vicente CD&#44; P&#233;rez-Miranda M&#46; Colocaci&#243;n de triple pr&#243;tesis para cierre de f&#237;stula traqueoesof&#225;gica&#46; Arch Bronconeumol&#46; 2021&#59;57&#58;698&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#41; Flexible bronchoscopy view showing a continuity defect in the posterior wall of the distal third of the trachea&#44; with visualization of esophageal stents and atrial septal defect occluder&#46; B&#41; Fluoroscopic view of the 3 normally positioned stents by flexible bronchoscopy through rigid bronchoscope&#46; C&#41; Chest CT image without intravenous contrast&#44; axial plane&#44; lung window showing the presence of the 3 devices used for closing the fistula&#46; D&#41; Plain post-anterior chest X-ray after intervention showing correct positioning of the 3 implanted devices&#46;</p>"
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                      "titulo" => "Endoscopic management of tracheoesophageal fistulas"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Ramai"
                            1 => "A&#46; Bivona"
                            2 => "W&#46; Latson"
                            3 => "A&#46; Ofosu"
                            4 => "E&#46; Ofori"
                            5 => "M&#46; Reddy"
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                        "tituloSerie" => "Ann Gastroenterol"
                        "fecha" => "2019"
                        "volumen" => "32"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Self-expandable metallic airway stents and flexible bronchoscopy long-term outcomes analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;P&#46; Saad"
                            1 => "S&#46; Murthy"
                            2 => "G&#46; Krizmanich"
                            3 => "A&#46;C&#46; Mehta"
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                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2003"
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Article information
ISSN: 15792129
Original language: English
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