Three-Dimensional Tracheo-Bronchial Reconstruction to Plan Endoscopic Stent Insertion for Malignant Upper Airway Stenosis

This retrospective single-center study evaluated the impact of 3D airway reconstruction on planning tracheobronchial stent insertion for malignant central airway obstruction (MCAO) in 136 patients from 2012 to 2024. Forty patients underwent stenting with preoperative 3D reconstruction, while 96 had standard planning.   
Both groups achieved a 96 percent airway patency restoration rate. However, the 3D reconstruction group showed a significant 17 percent reduction in operative time (median 40 minutes vs. 48 minutes; p=0.03) and a lower stent migration rate (5 percent vs. 17 percent; p=0.04). There were no differences in 30- or 90-day mortality. The 3D models, generated using open-source software from high-resolution CT scans, allowed detailed visualization of stenosis morphology and virtual endoscopy, facilitating optimal stent selection and placement. The observed improvements in efficiency and stent stability without additional cost or treatment delay indicate that 3D airway reconstruction could be considered for future practice.