The Montgomery tracheal prosthesis: actual solution for tracheal stenosis]

Tracheal stenosis is a disorder which is very difficult to diagnose in its early stages. Most cases are reffered to the hospital with an obstruction of at least 50% of the tracheal lumen, when dyspnea is already symptomatic. The cases with obstructive phenomena of over 70% represent immediately endoscopic emergencies, due to the risk of decompensation by adding the obstruction secondary to tracheo-bronchial secretions and bleeding. Initial management of a compromised central airway by endoscopic technique allows to obtain optimal conditions for the curative treatment. The main cause is malignancy and the for treatment are used endoscopic techniques with palliative visa. After restoring the permeability of the affected airways, stenting is mandatory to keep them open. Among the first stents invented, there was Montgomery type in 1965. Besides the silicon stent, there are the newest type, metallic or hybrid, which try to compensate disadvantages of silicone type, but with significant financial costs. Though Montgomery stent appeared more than 50 years ago, they are still used with good results, with clear advantages, especially in low incomes public health systems. The paper presents technical data, indications, advantages, disadvantages and techniques for effective placement. It also presents a well-documented clinical case of effective placement of a tracheal stent, with video-documentation of the whole procedure performed by a mix team: endoscopist and surgeon.