Broncho-vascular fistulas from self-expanding metallic stents: A retrospective case review
A 53-year-old male underwent right lung transplantation for severe chronic obstructive pulmonary disease (COPD). He subsequently developed right anastomotic dehiscence requiring Ultraflex® SEMS stent 14 mm × 40 mm placement in right main bronchus. Patient continued to have recurrent in-stent restenosis treated with Neodymium-doped yttrium aluminum garnet (Nd-YAG) laser, balloon bronchoplasty and electrocautery between 14 and 39 months post stenting. Two months following his last intervention, he presented with wheezing. Electrocautery was attempted to dilate his anastomotic stenosis, but was complicated by 400 ml of bleeding. On review, his CT scan of chest demonstrated metallic stent, bridging the anastomosis closely applied to posterior aspect of right main pulmonary artery []. He was eventually discharged home and died within a few days from massive hemoptysis.