Airway Stenting for Benign and Malignant Central Airway Obstruction: A Case Series

Abstract

Central airway obstruction (CAO) is a life-threatening condition caused by malignant or benign processes involving the trachea and main bronchi. Bronchoscopic airway stenting is an established intervention to restore airway patency, relieve symptoms, and stabilize patients, particularly in urgent or critical settings. However, its clinical role varies according to underlying etiology and disease context.We report a single-center case series of seven adult patients with symptomatic CAO who underwent bronchoscopic airway stenting. Six cases were associated with malignant disease, and one involved benign obstruction due to endobronchial tuberculosis. Interventions included rigid and/or flexible bronchoscopy, with adjunctive techniques such as balloon dilatation, cryotherapy, and argon plasma coagulation. Stent selection was individualized based on anatomical and etiological considerations. Airway stenting led to immediate improvement in respiratory status in all cases. In benign obstruction, stenting achieved sustained airway patency without significant complications. In malignant CAO, stenting served primarily as a palliative or bridging intervention, providing temporary stabilization and enabling further oncologic or supportive therapy. In critically ill patients, including those with impending airway collapse or post-cardiac arrest, stenting functioned as a lifesaving or salvage procedure. Complications included tumor ingrowth, mucus retention, and infection; no fatal stent-related procedural events occurred.Airway stenting is a versatile and effective modality for managing CAO. Its role differs by etiology, offering durable benefit in benign disease, palliative or stabilizing effects in malignancy, and potential life-saving intervention in selected critically ill patients. Individualized decision-making and multidisciplinary management remain essential to optimize outcomes.