ArticleJournal of thoracic disease2026
Management of malignant central airway stenosis with X-ray-guided Y-shaped covered self-expanding metallic stents: evaluating efficacy and safety.
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Malignant central airway stenosis (MCAS), a severe complication in advanced thoracic oncology, frequently causes debilitating dyspnea, necessitating stent placement for rapid alleviation. The management of carinal lesions, in particular, demands the deployment of an integrated Y-shaped stent to address the concomitant complex airway obstruction. X-ray guidance is a standard ancillary method employed in this technically challenging procedure. This study aimed to evaluate the efficacy and safety of X-ray-guided placement of Y-shaped covered self-expanding metallic stents (SEMS) in patients with MCAS. Methods: In this single-center retrospective study, 22 patients with MCAS involving the carina were enrolled and underwent X-ray-guided placement of Y-shaped covered SEMS. Outcomes assessed included technical and clinical success rates, comparisons of pre- and post-procedural physiological and quality-of-life metrics [airway stenosis grade, oxygen saturation on room air, modified British Medical Research Council (mMRC) dyspnea scores, and Karnofsky Performance Scores (KPS)], and complications. Results: The technical success rate of stent placement was 100%, and clinical success was achieved in 86.4% (19/22) of patients. The procedure resulted in significant symptomatic improvements: the airway stenosis grade decreased from 4.09±0.61 to 1.14±0.35, room-air oxygen saturation (in 19 evaluable patients) increased from (81.79±2.90)% to (94.00±3.21)%, mMRC dyspnea scores decreased from 3.95±0.21 to 2.73±0.70, and the KPS improved from 26.36±9.02 to 62.73±15.18 (all P<0.05). Complications requiring specific intervention occurred in 27.3% of patients, including secretion retention (18.2%) and restenosis due to granulation tissue hyperplasia (13.6%), with one patient experiencing both. No instances of stent migration or pneumothorax were recorded. The survival rates at 1, 3, and 6 months were 81.6%, 29.3%, and 11.7%, respectively, with a mean survival of 2.9 months. Conclusions: X-ray-guided implantation of the Y-shaped covered SEMS represents an effective and safe palliative strategy for MCAS. It reliably alleviates dyspnea, improves functional status, and creates a critical therapeutic window for definitive oncology care, all while maintaining an acceptable safety profile.
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