Broken Aboulker stents in the tracheal lumen.

Aboulker stents (AS) used in laryngotracheoplasty have yielded good results and few complications. Although the complications are few, a potentially serious complication is fracture of the stent. The Aboulker stent produced in France has been used with increasing frequency. Dr. Robin Cotton reported on a method of modifying the stent so that a metal tracheotomy tube could be inserted and wired to the stent. This method avoids the problem of suprastomal tracheal collapse often encountered with other stenting methods. However, though the method is generally effective, transverse break of the AS has occurred in 5 cases in 3 different institutions. When transverse break of the AS occurs, the airway can be compromised rapidly and removal of the stent can be treacherous. During attempts to remove the stent, any tilt of the distal broken segment can cause immediate complete occlusion of the tracheal airway. In this paper, 3 cases of transverse break of the AS are analyzed, and suggestions for avoiding stent breakage are outlined.