Stenting of Tracheobronchomalacia in Children Under 2 Years Old

## Introduction Severe Tracheobronchomalacia (TBM) in young children is congenital or acquired. Treatment is non-invasive ventilation, surgical ‘pexy’ or tracheostomy. Stenting aids ventilator dependent TBM children or TBM unmasked following airway reconstruction. We evaluated the technique, complications and clinical course of children under 2 undergoing stenting for TBM. ## Materials and Methods Retrospective analysis in single centre of children under 2 undergoing airway stenting by IR for TBM from April 2019 to April 2024. Data presented as median (range). ## Results Stent insertion in 14 children (11 male, 3 female), aged 4 months (18 days - 23 months) with weight 6.0 kg (2.6 -13.4 kg). Indication was ventilator dependency in 7 and TBM following airway reconstruction in 7. 13/14 children (93%) had emergency stenting; two intra-operative, the remainder from intensive care. 1 child (7%) had an urgent elective stent. 5 biodegradable, 3 retrievable nitinol and 6 bare metal stents were placed. Complications occurred in 2 (14%) including stent migration and undersizing. Ongoing intervention for TBM in 12 children (86%), including dilatation for granulation in 9 children (64%) and repeat stenting in 6 children (43%). One child required two repeat stents. Repeat stenting for temporary stent exchange in 4 children and stent upsizing in 2 children. Following stenting, discharge from ICU was 13 days (2 to 181 days) and home at 28 days (12 to 200 days). ## Discussion Stenting for TBM in children under 2 in extremis has a high technical success rate and can aid discharge from intensive care and home. However ongoing intervention is required to manage TBM.