Successful Bronchoscopic Balloon Dilation of Post Intubation Tracheal Stricture in a Cat
Acquired benign tracheal stenosis in cats, although uncommon, may result from congenital abnormalities, tracheal epithelial polyps, endotracheal tube pressure necrosis, abscesses, previous tracheal surgery, foreign bodies and inflammatory processes. A 3-year-old, neutered male, Persian cat was presented in respiratory distress, one week following general anesthesia for dental prophylaxis. Cervical and thoracic radiographs revealed a marked tracheal narrowing at the level of C5–T2. Tracheoscopy, performed with a flexible video bronchoscope (Pendax, EB 1575K, insertion tube diameter 5,2 mm), confirmed a circumferential stenosis with remaining patent lumen of 3,5 mm.
To describe the dilation procedure with a CRE™ wire guided balloon dilation catheter (Boston Scientific, inflated O.D 6–7–8 mm) placed aside a rigid scope (Karl Storz, 2,7 mm diameter, 0° angle view) as a treatment for segmental tracheal stenosis.
The balloon size was selected based on the degree of the narrowing and the diameter of the normal cervical trachea. Under endoscopic guidance, it was placed at the site of the stricture and inflated gradually to its median diameter for 30 sec.
Post dilatation bleeding was minimal and following the procedure the tracheal diameter was 6 mm. The cat recovered uneventfully and 2 weeks later was readmitted with retching. Tracheoscopy confirmed reformation of the stricture with a remaining diameter of 5 mm. It was dilated effortlessly with the tip of the flexible bronchoscope. The patient is free of clinical symptoms 9 months post-dilation.
Treatment of tracheal stenosis with balloon dilatation catheters is a safe and successful alternative, when tracheal surgery or stenting are declined.