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Tracheal Stent Placement 1166.e5

the desired location is achieved, the stent is of glucocorticoids and a 2-week course of Pearls
slowly deployed while being visualized. • Radiographs should be taken to assess stent • Tracheal stents are salvage procedures and
antibiotics.
do not cure tracheal collapse. It is common
VetBooks.ir be re-sheathed as long as less than 80% of placement, lungs, and airways 2-4 weeks to achieve a 70%-90% reduction in clinical
• If placement is inappropriate, the stent can
the stent has been deployed, and the process
signs if collapse is limited to the trachea or a
after stent placement and q 6 months
then can be restarted.
• After the stent is fully deployed, the delivery thereafter. 50% reduction in signs if there is comorbid
lower airway collapse.
device is carefully removed and the patient Alternatives and Their • Clients need to understand that ongoing
is re-intubated with a smaller endotracheal Relative Merits medical management will be required for
tube to facilitate recovery from anesthesia, • Medical management of tracheal collapse: at least some period after stent placement and
which should be carefully monitored. stents are considered only when medical potentially will be required for the remainder
management is inadequate. of the dog’s life.
Postprocedure • Extraluminal tracheal rings: an option for • After the stent has become embedded in the
• A slow, smooth recovery from anesthesia is extrathoracic tracheal collapse. Placement of airway, it cannot be removed if it fractures.
important. Sedatives such as acepromazine external stents is invasive and associated with Sometimes, a second stent can be placed
and butorphanol are used to prevent excite- important complications. Tracheal collapse inside the first. Procedures and Techniques
ment during recovery. is often found at multiple areas along the • Stent selection is key to success.
• Pulse oximetry is monitored until the patient length of the trachea, including intrathoracic
will no longer tolerate this monitoring. portions of the trachea. For these reasons, AUTHOR: Todd Cohen, DVM, DACVIM
• Aftercare for stent patients includes antitus- extraluminal ring stents have fallen out of EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
Thompson, DVM, DABVP
sives and bronchodilators (similar to before favor relative to intraluminal nitinol self-
stent placement), as well as a tapered course expanding stents.

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