A 65-year-old Caucasian female with history of CHF (EF<10%) who had a very severe motor vehicle accident 15 years ago. She was in the hospital for a number of months with a longterm tracheostomy. She had recurrent problems with her subglottic trachea. Approximately two years ago, she had a stent placed in her airway. She has had recurrent problems since that time with dyspnea and inability to walk. She is currently using a motorized wheelchair. She has had recurrent pneumonias. She has also had voice changes. A CT scan was done demonstrating a metallic stent in the majority of her trachea. There is a small area of narrowing above the trachea but beneath the cords (Figure 1). The inferior aspect of the stent is also narrowed by granulation tissue. The superior and inferior aspects of her stent are obscured by granulation.