Interventional Bronchoscopy under Extracorporeal Membrane Oxygenation Support for Severe Central Tracheal Stenosis: A Case Report and Literature Review
Abstract：Severe central tracheal stenosis is a life-threatening condition. If not promptly intervened, progressive hypoxia caused by airway obstruction can lead to impaired consciousness, organ failure, and even cardiac arrest in a short time. Due to the special location of the lesion and the severity of the condition, clinicians often face significant challenges during treatment. This study reports a 62-year-old male patient who was admitted with a half-month history of cough, sputum production, and wheezing. Computed tomography (CT) revealed tracheal lumen stenosis at the level of T1 vertebra, with a minimum cross-sectional area of approximately 0.30 cm × 0.35 cm and adjacent wall thickening. Bronchoscopy showed a scarred circumferential stenosis about 3–4 cm below the glottis. After the patient developed respiratory distress and hypoxemia, attempts to intubate were unsuccessful due to the stenotic site, and tracheotomy also failed to bypass the obstruction. Ultimately, the patient underwent bronchoscopic airway ablation and balloon dilation under extracorporeal membrane oxygenation (ECMO) support. After treatment, the tracheal diameter at the stenotic site reached 16 mm, achieving satisfactory therapeutic outcomes, and the patient was eventually discharged after recovery. This case highlights that when conventional ventilation strategies are limited in patients with severe airway stenosis, ECMO is a safe and effective respiratory support strategy. It not only rapidly improves oxygenation and ensures patient safety but also creates favorable conditions for bronchoscopic intervention. This case provides important references for the management of severe tracheal stenosis.
Keywords：Central tracheal stenosisBronchoscopic interventional therapyExtracorporeal membrane oxygenationRespiratory support
Publication Date：2025-06-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 546-549 )