Custom-made life-saving asymmetrical Y-stent for restenosis after carinal resection and reconstruction for tracheal cancer.

We report the case of a 50-year-old male treated with carinal resection and neocarina reconstruction for tracheal mucoepidermoid carcinoma. One month postoperatively, the patient developed severe respiratory failure due to restenosis and excessive dynamic airway collapse (EDAC) at the trachea-right main bronchus anastomosis. Initial management with balloon dilatation and a standard Dumon silicone stent failed due to stent migration. Given the complex postoperative airway anatomy, we designed a custom-made asymmetrical Y-shaped silicone stent. The stent successfully restored airway patency and prevented migration by anchoring in the right upper lobe bronchus. The patient was discharged in stable condition, and follow-up bronchoscopy confirmed long-term stent stability and airway patency. This case demonstrates that custom-designed stents can provide a life-saving solution in patients with complex post-surgical airway anatomy. Personalized stenting may be essential when conventional devices fail to address anatomical variability, especially after extensive airway reconstruction.