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Interventional procedures in the airway can be performed in interventional radiology suites or the operating room, by radiologists or other specialists. The most common therapeutic interventions carried out by radiologists are balloon dilatation, stenting, and the treatment of certain airway fistulas. These operations can be very challenging for anesthetists in terms of planning, airway management, the identification and treatment of procedural complications and postoperative care. In particular, a multidisciplinary approach to decision‐making and planning is important to obtain the best results. [ABSTRACT FROM AUTHOR]

In this article the authors discuss various techniques for the imaging of tracheobronchomalacia (TBM). TBM refers to a softening of the wall of the airway that leads to expiratory collapse. According to the authors, traditional methods of diagnosing TBM include rigid or flexible bronchoscopy and bronchography, which require general anaesthesia. The authors say that the multidetector computed tomography (MDCT) is an important technique for the evaluation of TBM.

Objectives: Metallic tracheobronchial stents are placed at our institution (tertiary referral academic specialist children’s hospital) by the interventional radiology unit following a multidisciplinary “tracheal team” meeting. Indications include tracheobronchial stenosis (congenital or acquired), extrinsic compression and tracheobronchomalacia. This presentation reviews the experience of 50 metallic stents in 26 children seen consecutively from September 1999 to August 2003.Methods: Data were collected prospectively and information regarding the following was recorded: patient demographics and indications, type of stent used, follow-up procedures required, and survival rates.Results: Of the 26 patients, 12 were male and 14 female with ages ranging from 7 weeks to 16 years (median, 8 months). A total of 40 procedures were carried out involving the placement of 50 stents (types used were Palmaz, Wall Stent, Symphony, and Smart Control). Stent location was as follows : trachea (n = 27), left main bronchus (n = 17), left lower lobe bronchus (n = 2) and right main bronchus (n = 4). Twenty-four patients have required follow-up bronchography ± flexible bronchoscopy, with 16 needing further procedures. Of these, 10 had balloon dilatations alone and 6 had these in combination with additional stent intervention. Complications incude hemorrhage, stent collapse, and formation of granultions. There have been 8 deaths.Conclusions: In summary, we believe that metallic tracheobronchial stenting has value in the management of lower airway problems in children previously viewed as having an extremely poor prognosis. It is vital, however, that it is performed in a unit with a multidisciplinary team consisting of interventional radiologists, otolaryngologists, cardiothoracic surgeons, pulmonologists and intensivists. [Copyright &y& Elsevier]

Pulmonary artery slings are rare congenital anomalies seen only on the left side. The presence of right pulmonary artery (RPA) sling is extremely rare. We report a case of a RPA sling with a single lung associated with tracheal stenosis and its management., (© 2013 Wiley Periodicals, Inc.)