Treatment of Central Airway Stenosis With Self-Expanding Y Stents: Easy and Innovative Technique With a Single Wire Guide.

[OBJECTIVES] Central airway obstruction (CAO) involves the narrowing of the trachea, carina, and main bronchi. This study describes a technique for placing a self-expanding metallic Y-stent using a single guidewire for the palliative management of inoperable malignant stenosis near the carina, evaluating its efficacy and safety.

[MATERIALS AND METHODS] We conducted a retrospective analysis of all patients with severe malignant carinal stenosis who were treated with a customized self-expanding metallic Y-stent at our institution between January 2020 and December 2024. In all cases, the left bronchial branch of the stent was positioned using the Seldinger technique with a single guidewire.

[RESULTS] The single-guidewire Seldinger technique simplified the procedure, resulting in a significantly shorter stent placement time (38 vs. 51 min; p < 0.0001) and reduced general anesthesia time (53 vs. 71 min; p ≤ 0.0001) compared to a double-guidewire approach. Furthermore, it minimized the number of required X-ray exposures (0-1 vs. 4-5 images; p < 0.0001) and lowered the risk of guidewire dislodgement. No immediate complications were reported.

[CONCLUSION] The placement of a self-expanding Y-stent using a single left-sided guidewire is an efficacious and feasible approach for maintaining airway patency in patients with severe malignant carinal stenosis, offering a simpler and more efficient procedural alternative.