Limited but encouraging outcomes have been reported with patient-specific stents, designed and manufactured based on the patient’s corrected anatomy.1–4 These personalised stents will probably benefit most if bifurcated and/or of complex shape with multiple angles, diameters and lengths to consider. From our (still limited) experience, anastomotic strictures following airway surgeries may represent a particularly appealing application (lung transplantation, sleeve lobectomy, tracheal and carinal resections with airway reimplantation). Here, we report the first use of a customised ‘double-bifurcated’ stent to treat multifocal airway stenoses after a complex airway surgery. This 56-year-old patient underwent in 2016 a tracheal and carinal resection for an adenoid cystic carcinoma, with implantation of the bronchus intermedius (BI) to a neocarina and of the right upper lobe (RUL) in the trachea. Unfortunately, there was subsequent development of highly symptomatic (dyspnoea, retention pneumoniae) stenoses of the trachea and BI. Since August 2019, most commercially available stents (15 in the past 27 months; 9 Bonastent, 8 Aerstent straight, 1 Aerstent bifurcated, 1 Novatech silicone stent) had to be removed for severe adverse events: (1) bifurcated stents were not suited (the right branch was too …

中文翻译：

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“双分叉”支架：当 3D 不可行时


据报道，根据患者矫正的解剖结构设计和制造的患者专用支架取得了有限但令人鼓舞的结果。1-4 如果分叉和/或具有多个角度、直径和长度的复杂形状，这些个性化支架可能会受益最多。根据我们（仍然有限）的经验，气道手术后的吻合口狭窄可能是一个特别有吸引力的应用（肺移植、袖状肺叶切除术、气管和隆突切除伴气道再植入）。在这里，我们报告了首次使用定制的“双分叉”支架来治疗复杂气道手术后的多灶性气道狭窄。这位 56 岁的患者于 2016 年因腺样囊性癌接受了气管和隆突切除术，并将中间支气管 (BI) 植入新隆突，并将右上叶 (RUL) 植入气管。不幸的是，随后出现了严重症状的气管和脑梗塞（呼吸困难、潴留性肺炎）狭窄。自 2019 年 8 月以来，大多数市售支架（过去 27 个月内有 15 个支架；9 个 Bonastent、8 个 Aerstent 直支架、1 个 Aerstent 分叉支架、1 个 Novatech 硅胶支架）因严重不良事件而必须移除：(1) 分叉支架不适合（右边的分支太……