External Fixation of Proximal Tracheal Airway Stents: A Modified Technique  Adnan Majid, MD, Sebastian Fernandez-Bussy, MD, Michael Kent, MD, Erik Folch,

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External Fixation of Proximal Tracheal Airway Stents: A Modified Technique  Adnan Majid, MD, Sebastian Fernandez-Bussy, MD, Michael Kent, MD, Erik Folch, MD, MS, Liliana Fernandez, MD, FCCP, George Cheng, MD, PhD, Sidhu P. Gangadharan, MD, FCCP  The Annals of Thoracic Surgery  Volume 93, Issue 6, Pages e167-e169 (June 2012) DOI: 10.1016/j.athoracsur.2012.01.094 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) An intravenous catheter is introduced into the trachea through the sten. (B) A 0-0 silk suture is introduced into the airway, and the Endo Close suturing device is introduced into the airway through the stent, 1 cm proximal to the angiographic catheter (between the first and second tracheal ring). (C) The ends of the suture are introduced into the silicone button and secured by a knot. The Annals of Thoracic Surgery 2012 93, e167-e169DOI: (10.1016/j.athoracsur.2012.01.094) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Under direct bronchoscopic guidance, a 16-gauge angiographic catheter was introduced between the second and third tracheal ring at 12 o'clock. (B) The needle was retracted, and a 0-0 silk suture was introduced through the catheter into the airway. (C) The silk was grasped with a rigid forceps and pulled proximal and out from the rigid barrel. (D) The Endo Close suture device was introduced into the airway 1 cm proximal between the first and second tracheal ring at 12 o'clock. (E) The two ends of the suture were introduced through a silicone button and secure by a knot. (F) The external silicone button has been sutured in place. The Annals of Thoracic Surgery 2012 93, e167-e169DOI: (10.1016/j.athoracsur.2012.01.094) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions