Collapsed Trachea: Mechanical Management

Many middle-aged toy and miniature dogs develop collapsing trachea. The cause and most effective management of this disorder are still controversial, with some, but not all, dogs responding to medical therapy. This study reports on 24 client-owned dogs that did not respond to conventional therapy. They were managed with implantation of an intraluminal self-expanding stainless-steel endoprosthesis. The stents are implanted with a delivery catheter via fluoroscopy. The endoprosthesis is longitudinally stretched and springs back to its original diameter after deployment. In 23 of the 24 patients, implantation led to immediate improvement of clinical signs. Two of the 24 dogs died within 6 days of implantation; one dog never showed any sign of improvement, and the other died after sudden onset of emphysema. Perforation of the tracheal mucosa by the device was suspected, although the precise location could not be found either by endoscopy or surgical exploration. This appears to be an effective, minimally invasive, and comparatively easy method of managing patients with severe tracheal collapse.

COMMENTARY: This article is a review of 24 cases of tracheal collapse refractory to conventional treatment. The management technique discussed provides an attractive alternative to surgery.

COMMENTARY: This article presents evidence that an endoscopically placed intraluminal tracheal stent may be the newest and least invasive technique for treatment of severe tracheal collapse in those patients in which other therapeutic measures fail. This technique could provide veterinarians a valuable and much-need tool in the management of those challenging cases.

Management of advanced tracheal collapse in dogs using intraluminal self-expanding biliary wall stents. Moritz A, Schneider M, Bauer N. J VET INTERN MED 18:31-42. 2004.