# Treatment of Central Airway Stenosis With Self‐Expanding Y Stents: Easy and Innovative Technique With a Single Wire Guide

## TL;DR

A new technique using a single wire guide to place a Y-shaped stent in the airway is shown to be faster and safer for treating severe airway blockage.

## Contribution

A novel single-guidewire technique for Y-stent placement in malignant carinal stenosis is introduced and validated.

## Key findings

- The single-guidewire technique reduced stent placement time and anesthesia duration significantly.
- The method minimized X-ray exposure and guidewire dislodgement risks without immediate complications.
- The approach achieved high technical success in maintaining airway patency for malignant stenosis.

## Abstract

Central airway obstruction (CAO) involves the narrowing of the trachea, carina, and main bronchi. This study describes a technique for placing a self‐expanding metallic Y‐stent using a single guidewire for the palliative management of inoperable malignant stenosis near the carina, evaluating its efficacy and safety.

We conducted a retrospective analysis of all patients with severe malignant carinal stenosis who were treated with a customized self‐expanding metallic Y‐stent at our institution between January 2020 and December 2024. In all cases, the left bronchial branch of the stent was positioned using the Seldinger technique with a single guidewire.

The single‐guidewire Seldinger technique simplified the procedure, resulting in a significantly shorter stent placement time (38 vs. 51 min; p < 0.0001) and reduced general anesthesia time (53 vs. 71 min; p ≤ 0.0001) compared to a double‐guidewire approach. Furthermore, it minimized the number of required X‐ray exposures (0–1 vs. 4–5 images; p < 0.0001) and lowered the risk of guidewire dislodgement. No immediate complications were reported.

The placement of a self‐expanding Y‐stent using a single left‐sided guidewire is an efficacious and feasible approach for maintaining airway patency in patients with severe malignant carinal stenosis, offering a simpler and more efficient procedural alternative.

A single guidewire Seldinger technique enables accurate placement of a customized self expanding Y stent in malignant carinal stenosis. The wire stabilizes the left main bronchus, where carinal angles are more variable, allowing sequential deployment of the bronchial limbs followed by the tracheal limb. Compared with a doubleguidewire method, this approach significantly reduces procedure and anesthesia times, limits fluoroscopic exposures, and maintains a high technical success rate without immediate complications.