Nonocclusive Balloon Dilation in Severe Tracheobronchial Stenosis

BACKGROUND: Balloon tracheobronchial dilation is a key technique for managing central airway stenosis. Conventional occlusive balloons interrupt ventilation and oxygenation, limiting the duration and safety of dilation. The objective of this study was to evaluate the clinical outcomes of tracheobronchial stenosis dilation using a nonocclusive balloon and to describe relevant technical aspects of its application. METHODS: A retrospective cross‑sectional study was conducted, including all patients with central airway stenosis who underwent dilation with a nonocclusive balloon at a tertiary center. In all cases, stenosis severity was ≥50%, confirmed by endoscopic or tomographic assessment, and associated with compatible symptoms. Demographic characteristics, stenosis features, procedural details, oxygenation parameters, and complications were collected. RESULTS: Sixteen procedures were performed in 11 patients; 6 stenoses (54.5%) were malignant. The trachea was the most frequent location (n=8; 72.7%). The median stenosis severity was 83%. The mean minimum oxygen saturation during the procedure was 96.1%±3.6%, increasing to 98.6%±0.8% at the end of the procedure (P=0.009). Most procedures (n=14; 87.5%) included 3 consecutive dilation cycles. In 2 cases (12.5%), a single prolonged cycle was performed, lasting 300 and 600 seconds, respectively. Airway stents were placed in 6 procedures (38%), all in malignant stenosis. Mild complications occurred in 2 patients (13%), consisting of minor or moderate bleeding, not related to balloon dilation. CONCLUSION: Nonocclusive balloon dilation provides effective treatment of tracheobronchial stenosis while maintaining ventilation and oxygenation. This technique enables longer, safer dilation cycles by eliminating the need for apnea.