A narrative review of new research progress regarding the use of airway stents in benign airway stenosis

Zou, Hai; Zhang, Jun; Zhan, Kan; Mou, Xiaozhou; Zhu, Biao

doi:10.1080/17476348.2022.2099379

Cited by 5 publications

(2 citation statements)

References 40 publications

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“…External fixation was performed in 21 (31.8%) implantations and, except in two patients, was performed immediately after deployment of the stent. External fixation appears to be a suitable supplement to implantation, especially for stents in the upper trachea and in cases of posttracheotomy stenoses, where there is a greater risk of migration [ 8 , 10 , 11 ]. Although it prolongs the procedure and makes the implantation more difficult, the stent does not have to produce a significant radial expansion force, which does not allow dislocation but does lead to mucosal irritation.…”

Section: Discussionmentioning

confidence: 99%

“…In benign stenoses, we encountered a relatively large number of stent migrations, at a frequency of approximately 20% [11]. This incidence has been previously described to be greater, especially in cases of upper tracheal narrowing treated with either silicone stents or SEMSs [10,[13][14][15][16]. Dumon et al reported a frequency of migrations in 18.6% of all silicone stents inserted for benign tracheal stenosis [17].…”

Section: Stent Migrationmentioning

confidence: 96%

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Biodegradable tracheal stents: our ten-year experience with adult patients

Stehlik,

Guha,

Anandakumar

et al. 2024

BMC Pulm Med

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Background Biodegradable (BD) stents made from polydioxanone have been used only in human airways. These stents combine the advantages of classical tracheal stents, and fewer side effects are expected due to their biocompatibility and their time-limited presence in airways. However, new clinical consequences have arisen. Here, the authors share their experiences with BD stents for tracheal indications, focusing on their safety and efficacy. Methods This was a retrospective review of a collected database of adult patients who underwent implantation of biodegradable tracheal stents between September 2013 and December 2022 at the Department of Respiratory Medicine of the 1st Faculty of Medicine in Prague and Thomayer University Hospital. The indications included functionally significant nonmalignant tracheal stenosis and tracheomalacia. Self-expandable, biodegradable, polydioxanone tracheal stents manufactured by ELLA-CS Ltd. (Hradec Kralove, Czech Republic) were implanted during rigid bronchoscopy under general anaesthesia. All patients were followed up in the department and were provided with the necessary care. The main efficacy and safety parameters and relationships were analysed using descriptive statistics and Fisher´s exact, Wilcoxon and Kruskal‒Wallis tests. Results A total of 65 stents were implanted in 47 adult patients. During the first two months after implantation, when adequate function was expected, the stent was found to be effective in 26 out of 39 patients who completed this period (66.7%). The clinical effectiveness reached 89.7%, as early restenoses were mostly mild and necessitated treatment in only 4 patients. The frequencies of significant mucostasis, migration and granulation tissue growth were 2.6%, 7.5% and 23.1%, respectively, during this period. Thirty-four participants completed the half-year follow-up period after the first or second stent insertion, and some were followed up beyond this period. Poor control of symptoms, the development of restenosis and the need for interventions were characteristic of this period as the stents degraded. Twenty-two patients who experienced remodelling or stabilization of the tracheal lumen achieved a stent-free state. Seven patients underwent subsequent surgical treatment. Conclusions BD stents are safe and provide adequate tracheal support until they begin to degrade. The use of BD stents necessitates close monitoring of patients and accurate treatment of possible restenosis. Trial registration Based on project NT14146 – Biodegradable stents in the management of the large airways (2013–2015, MZ0/NT), registered on May 1, 2013, in the Research and Development and Innovation Information System of the Czech Republic and at ClinicalTrials.gov (reg. no. NCT02620319, December 2, 2015).

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Section: Discussionmentioning

confidence: 99%

Section: Stent Migrationmentioning

confidence: 96%

Biodegradable tracheal stents: our ten-year experience with adult patients

Stehlik,

Guha,

Anandakumar

et al. 2024

BMC Pulm Med

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Further experience with polydioxanone airway stents in children

Morante‐Valverde,

Díaz,

Luna‐Paredes

et al. 2024

Pediatric Pulmonology

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IntroductionThe aims of this study were to update our experience with biodegradable polydioxanone (PDO) airway stents in children, focusing on effectiveness and safety, and to analyze the factors involved in the different outcomes observed.Materials and MethodsRetrospective study of patients managed with PDO stents from 2012 to 2023. Variables collected: demographics, comorbidities, indication, clinical baseline, stent size, location, complications, clinical outcome, and time of follow‐up. Statistical analyses were performed to detect the eventual contribution of variables in the different outcomes observed.ResultsFifty‐four PDO stents were placed in 26 patients (median age, 4 months). All showed severe symptoms of central airway obstruction due to tracheomalacia in nine patients, bronchomalacia five, tracheobronchomalacia 10, and tracheal stenosis two. Stent placement was uneventful in every case: 29 stents in the trachea and 25 in the main bronchi. 53.8% of patients needed successive stenting, and all exhibited comorbidities. Complete clinical resolution was observed in eight cases (30.7%), partial improvement in 13 (50%), unchanged in 4 (15.3%), and worsened in one. Age had a significant positive impact on outcome (6 vs. 3 months; p = 0.024). Additionally, smaller stents were associated with a better outcome (20 vs. 26 mm; p = 0.044). Granulation tissue was the most frequent complication (34.6%). Five patients (19.2%) died due to severe comorbidities, follow‐up was complete in survivors (median, 58 months).ConclusionsPDO stents are safe and effective when dealing with severe tracheobronchial obstruction. Stent‐related granulation tissue continues to be a relevant matter of concern. This issue, together with increased degradation times, deserves further research.

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