Medical disclaimer: This page is for educational purposes only. It does not constitute medical advice and must not be used as a substitute for consultation with a qualified doctor. If you or a family member are experiencing breathing difficulty or have been referred for airway stenting, please seek immediate medical evaluation. Last reviewed May 2026 by Dr. Kunal Waghray, MD DM DNB MNAMS EDRM.
Airway Stenting in Hyderabad
A blocked airway does not stay stable. In malignant central airway obstruction, breathlessness can progress from mild to critical within days. A tumour growing inside the trachea, or scarring that has narrowed the windpipe to a fraction of its normal diameter, is a clinical emergency that benefits from urgent bronchoscopic treatment. In many cases, a single session of airway stenting can restore meaningful airflow before the patient leaves the procedure room.
Dr. Kunal Waghray, MD DM DNB MNAMS EDRM, is an interventional pulmonologist in Hyderabad who trained at Amrita Institute of Medical Sciences, Kochi. He performs both flexible and rigid bronchoscopic airway stenting at Respire Airway Clinics, Basheer Bagh and Jubilee Hills.
When an Airway Blocks: Conditions That Lead to This Referral
Not every breathlessness leads to stenting. The patients referred for this procedure typically have a specific, anatomically definable point where the airway has narrowed or is being compressed from outside. That narrowing is what the stent addresses.
Malignant obstruction
Lung cancer is the most common cause of malignant central airway obstruction in India. Tumours can grow into the trachea or a main bronchus, or press on the airway from the outside. Oesophageal cancer is another cause, compressing the posterior tracheal wall as the tumour enlarges. Stenting in this setting restores airflow while systemic treatment (chemotherapy or immunotherapy) addresses the underlying disease.
Benign stenosis
In Indian clinical practice, post-intubation and post-tracheostomy tracheal stenosis is a significant cause of benign airway narrowing. Patients who spent time on a ventilator in an ICU sometimes develop scarring at the cuff site months after discharge. Post-tuberculosis bronchial stenosis is a particularly common benign cause in India, and is rarely mentioned on competitor pages. These patients present with progressive breathlessness and stridor, often years after the original TB treatment ended.
External compression
Some obstructions originate outside the airway wall entirely. A mediastinal mass, lymph node enlargement from lymphoma, or a goitre pressing on the trachea can narrow the lumen without invading it. In these cases, stenting maintains the airway diameter until the compressing structure responds to its own treatment.
What Airway Stenting Is, and What It Is Not
A bronchial or tracheal stent is a hollow tube, usually made of silicone or a metal alloy, that sits inside the airway and holds the walls apart. It does not cure the condition causing the obstruction. What it does is give the airway a structural scaffold so that breathing is possible while the underlying problem is treated or palliated.
The placement is done through a bronchoscope: a flexible or rigid camera-equipped tube passed through the mouth into the trachea and bronchi. There is no incision. No surgeon cuts the neck or chest wall. The word "stenting" sounds surgical, but the procedure is entirely endoscopic.
Types of Airway Stents Used in Bronchoscopic Practice
There are two main categories, and the choice between them affects how long the stent stays in, how it behaves in the airway, and whether it can be removed later.
Silicone stents (Dumon stent)
Preferred for benign diseaseMade from medical-grade silicone; require a rigid bronchoscope and a dedicated deployer for placement. Because silicone does not embed into the airway wall, these stents can be repositioned or removed with relative ease. Preferred for benign conditions where the goal is temporary support followed by stent removal.
Self-expanding metallic stents (SEMS)
Preferred for extrinsic compressionMade from nitinol, a nickel-titanium alloy. Can be delivered through a flexible bronchoscope under conscious sedation. Exert continuous radial force against the airway wall, making them effective for extrinsic compression. Uncovered SEMS can embed into the mucosa over time, making removal difficult.
Covered SEMS
Malignant obstructionA silicone or polyurethane membrane over the metal framework prevents tumour ingrowth through the stent mesh and allows for removal if needed. The standard choice for malignant obstruction where the stent may need to be exchanged.
Uncovered SEMS
Selected cases onlyIntegrate with the airway wall quickly. Occasionally used when permanent patency is the goal and retrievability is not a concern. Not appropriate for most benign indications.
"When I'm choosing between silicone and a covered metal stent, I'm thinking about two things: Is this benign or malignant, and do we need to take this out later? For a post-intubation stenosis in a young patient, I want a stent I can remove cleanly at six to twelve months. Silicone gives me that. For a lung cancer patient with extrinsic compression, a covered SEMS deployed through a flexible scope is often the better fit, because we need quick patency and the patient may not tolerate general anaesthesia. The stent type is a clinical decision, not a default."
Who Needs an Airway Stent: Clinical Decision Criteria
Not every case of airway narrowing requires a stent. Some patients with early or mild stenosis respond to balloon dilatation alone, without leaving a permanent implant in the airway. Others with resectable disease are better served by thoracic surgery. The indication for stenting is usually one of the following:
Patients with very distal lesions, active airway infection, or coagulopathy that cannot be corrected may not be candidates at a given time. A bronchoscopic assessment is needed before any decision about stenting is made.
The Procedure: What Happens During Airway Stent Placement
Before the procedure
Patients fast for at least six hours before the procedure. A baseline bronchoscopy or CT scan of the chest will already have confirmed the site and extent of narrowing. Blood tests are checked for clotting function. Patients with severe breathlessness may require oxygen or non-invasive ventilation support while waiting.
During stent deployment
The patient receives conscious sedation through an intravenous line, along with topical lignocaine applied to the airway. For flexible bronchoscopy-based SEMS placement, moderate conscious sedation is usually sufficient. For silicone stenting through a rigid bronchoscope, deeper sedation or general anaesthesia is required.
The bronchoscope is passed through the mouth into the trachea. The stenotic segment is visualised, its length and diameter measured, and in malignant cases, any intraluminal tumour is debulked before stenting. The stent is then advanced through or alongside the bronchoscope and deployed under direct vision, with fluoroscopic guidance confirming position. The entire procedure typically takes 30 to 60 minutes, depending on complexity.
After the bronchoscope is withdrawn
Breathing usually improves within minutes of successful stent deployment. The patient is monitored in a recovery area and observed for at least two to four hours. A chest X-ray is taken before discharge to confirm stent position.
Recovery After Airway Stenting
Most patients go home on the day of the procedure or after one night of observation. A hoarse voice, mild sore throat, and a dry cough are normal for the first few days as the airway adjusts to the stent. These are not signs of a problem.
Patients are asked to stay well hydrated, use prescribed nebulisations to keep secretions mobile, and avoid vigorous physical activity for one week. Follow-up bronchoscopy is scheduled at six to eight weeks to check stent position and clear any mucus plugging.
Contact the clinic or go to an emergency department if:
- Breathlessness becomes suddenly worse after discharge
- There is fever above 38.5°C with increased cough or coloured sputum
- There is significant bleeding beyond a small pink tinge in the first day
Outcomes: What the Evidence Shows
A 2023 systematic review published in Cureus (PMCID: PMC10366558), covering 1,382 patients across 27 studies, found that endobronchial stent placement for malignant central airway obstruction was associated with significant post-procedure improvement in pulmonary function testing and blood gas parameters. Complication rates in one large cohort reached 10.8%, which points to the importance of skilled endoscopic follow-up.
Indian data supports the utility of bronchoscopic airway intervention in benign disease as well. A study from a tertiary care centre in India (PMCID: PMC3938713) reported that 85% of patients with tracheal stenosis achieved successful symptom relief with multidisciplinary bronchoscopic management. Post-intubation and post-tracheostomy stenosis accounted for 85% of cases in that cohort.
These figures apply to populations, not to individual patients. Outcomes vary with the cause of obstruction, stent type, underlying disease trajectory, and post-procedure follow-up adherence. No outcome can be guaranteed in advance.
Frequently Asked Questions
What is airway stenting?
Airway stenting is a bronchoscopic procedure in which a hollow tube (a stent) is placed inside the trachea or a bronchus to hold a narrowed or obstructed airway open. It is performed through a bronchoscope passed through the mouth, without any surgical incision. The stent keeps the airway walls apart so that the patient can breathe.
How is a bronchial stent placed?
The stent is deployed through a flexible or rigid bronchoscope under sedation or anaesthesia. The bronchoscope is passed through the mouth into the airway. Once the narrowed segment is visualised and measured, the stent is advanced through the bronchoscope and released at the correct position, where it expands to hold the airway open. Fluoroscopy confirms placement.
Is tracheal stenting painful?
The procedure itself is done under sedation or anaesthesia, so the patient does not feel pain during stent placement. After the procedure, a sore throat, mild hoarseness, and a dry cough are common for one to three days. Significant post-procedure pain is not typical. If chest pain develops or worsens after discharge, the treating doctor should be contacted.
How long does an airway stent last?
Duration depends on the underlying condition. For malignant obstruction, stents typically remain for the duration of palliation. For benign conditions such as post-intubation stenosis, silicone stents are usually kept for six to eighteen months, with the aim of stent removal once the airway has stabilised. Some patients with refractory stenosis require longer stenting.
Can a tracheal stent be removed?
Silicone stents and covered self-expanding metallic stents can generally be removed bronchoscopically, particularly when placed for benign disease. Uncovered metallic stents that have been in place for a long time may embed into the airway wall, making removal more complex. The removability of a stent is one of the key factors that shapes the choice of stent type at the time of placement.
What are the risks of airway stenting?
The main risks are mucus plugging (the most common early complication, managed at follow-up bronchoscopy), stent migration, granulation tissue forming at the stent edges, and, less commonly, stent fracture or airway infection. The procedure carries a small risk of bleeding during any associated tumour debulking. Overall complication rates in published series are in the range of 10 to 15% across all stent types, with most complications manageable bronchoscopically.
What is the difference between a silicone stent and a metal stent?
Silicone stents (such as the Dumon stent) are made from medical-grade silicone, require a rigid bronchoscope for placement, and can be removed or repositioned relatively easily. They are preferred for benign disease. Metal stents (SEMS) are made from nitinol and can be delivered through a flexible bronchoscope under conscious sedation. They exert continuous radial force, making them effective for extrinsic compression. Covered SEMS prevent tumour ingrowth and allow for some retrievability; uncovered SEMS integrate with the airway wall and are generally not retrievable.
How soon after stent placement will I breathe better?
Many patients notice an improvement in breathing within minutes of the procedure ending, as the airway lumen is restored. For others, full symptomatic relief takes 24 to 48 hours as any procedural swelling settles. The degree of improvement depends on the cause and extent of the obstruction and on what other treatments are running alongside stenting.
Clinical References
- Umar Z, et al. Malignant Airway Obstruction and Endobronchial Stent Placement: A Systematic Review. Cureus. 2023. PMCID: PMC10366558.
- Tracheal Stenosis: Experience at a Tertiary Care Centre in India. Indian J Otolaryngol Head Neck Surg. 2013. PMCID: PMC3938713.