Background: Bifurcation stents are often required in patients with malignant airway obstruction or fistulization involving the main carina. The silicone Y stent is the most used but remains challenging to place. The self-expanding metallic Y (SEM) stent appears easy to use. The objective is to report the feasibility, efficacy, and tolerance of SEM Y stent compared to silicone Y stent in patients with malignant tumors involving the main carina.

Patients and methods: This retrospective single center study was performed between May 2004 and May 2017. All patients with malignant carina involvement treated with a bronchial Y stent were included.

Results: Forty silicone Y stents and 38 SEM Y stents were placed. Seven stenting placements failed in the silicone Y group but none in the SEM Y stent group (p=0,008). The median duration of the procedure was 80 min (25-210) in the silicone Y group and.50 min (25-110min) in the SEM Y group (p=0,001). There was no significant difference in terms of early or late complications between the 2 groups.

Nine silicone Y stents (26.5%) and 7 SEM Y stents (18.4%) were removed (p=0,4). The median survival time following stent insertion was 171 days (Interquartile range (IQR) : 53- 379) in the silicone Y group and 104 days (IQR: 53-230) in the SEM Y group.

Conclusion: If silicone Y stent remains the best solution for benign obstruction, SEM Y stent seems to be an easy alternative with no difference in terms of complication or ablation for malignant lesions involving the main carina.