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Case Reports in Pulmonology
Volume 2016, Article ID 6742349, 4 pages
http://dx.doi.org/10.1155/2016/6742349
Case Report

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

1Department of Chest Medicine, Erasme University Hospital, Free University of Brussels, 1070 Brussels, Belgium
2Department of Chest Medicine, La Reunion University Hospital, Saint Denis, 97400 La Réunion, France
3Department of Medical Oncology, Erasme University Hospital, Free University of Brussels, 1070 Brussels, Belgium
4Department of Thoracic Surgery, Erasme University Hospital, Free University of Brussels, 1070 Brussels, Belgium

Received 8 December 2015; Revised 22 February 2016; Accepted 6 March 2016

Academic Editor: Reda E. Girgis

Copyright © 2016 Benjamin Bondue et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.